Sung JJ et al. (2008) Meta-analysis: treatment of hepatitis B infection reduces risk of hepatocellular carcinoma. Aliment Pharmacol Ther 28: 1067–1077

Chronic HBV infection increases the risk of hepatocellular carcinoma (HCC) by 200-fold. A recent meta-analysis by Sung et al. has shown that treatment of chronic HBV infection with interferon or oral antiviral therapy significantly reduces the risk of HCC developing.

Five computerized databases and lists of abstracts presented at major international conferences were searched to identify studies that reported the incidence of HCC in patients with chronic HBV infection who received interferon therapy, pegylated interferon therapy, nucleotide or nucleoside analogs, or no HBV therapy. Of the 1,136 studies identified, 12 that examined the effects of interferon therapy and 5 that studied lamivudine antiviral monotherapy (1 of which also assessed adefovir in patients with lamivudine resistance) were included in the final analysis.

The incidence of HCC was significantly lower in patients who received interferon therapy or antiviral agents than in those who did not receive either treatment (interferon therapy: relative risk [RR] 0.66; antiviral therapy: RR 0.22). The reduced risk of HCC associated with interferon therapy was most pronounced in patients who also had early cirrhosis (RR 0.53), whereas the beneficial effect of antiviral therapy was most profound in individuals who tested positive for HBV e antigen (RR 0.21).

The authors suggest that the protective effects of interferon and antiviral therapy against HCC in patients with chronic HBV infection occur because these agents at least partially resolve liver fibrosis.