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Background & Aims: The effects of interferon therapy in chronic hepatitis C patients on survival are unclear. Our objective was to analyze survival among a large cohort of chronic hepatitis C patients. Methods: We used a retrospective cohort study design in the setting of 7 university hospitals and 1 regional core hospital in Japan. Our study included 2889 patients with histological-proven chronic hepatitis C: 2430 patients received interferon therapy, and 459 patients were untreated. For intervention, the median dose and duration of interferon administration was 480 million units and 137 days, respectively. For measurements, survival status was confirmed by medical records or direct questionnaires. The effect of interferon therapy on survival was assessed by standardized mortality ratio (SMR) based on published mortality among the Japanese general population and by risk ratio calculated by proportional hazards regression. Results: Thirty of 459 untreated patients, 7 of 817 virologic sustained responders, and 49 of 1613 nonresponders died in 5.4-years follow-up. Fifty-eight (67%) of 86 patient deaths were due to liver diseases (39 to hepatocellular carcinoma). Compared with the general population, overall mortality was high among untreated patients (SMR: 1.9; CI: 1.3–2.8) but not among interferon-treated patients (SMR: 0.9; CI: 0.7–1.1). The risk of death was reduced, compared with untreated patients, among interferon-treated patients (risk ratio for overall death: 0.367; CI: 0.236–0.596; for liver-related death: 0.284; CI: 0.164–0.494) and among sustained responders (risk ratios: 0.148; CI: 0.064–0.343 and 0.050; CI: 0.012–0.216). The risk of liver-unrelated deaths remained unchanged. Conclusions: Interferon therapy improved survival of chronic hepatitis C patients by preventing liver-related deaths. GASTROENTEROLOGY 2002;123:483-491

PURPOSE: Recently', radio-frequency ablation (RFA) therapy has been developed for the treatment of hepatocellular carcinoma (HCC). But the therapeutic benefits of RFA, as an alternative to percutaneaus ethanol injection (PEI), has yet to be thoroughly investigated We compared tbe efiect of rumor necrosis between RFA and PEI using histological findings and telomerase activities with biopsy samples METHODS: Over a one year period, we treated 21 HCC cases using RFA. We used Le Veen Needle e and RF2000 generatoff~(Boston Scientific Co.) In all cases, we first executed a tumor biopsy betbre therapy, and we studied the histologmal findings of H-E stain and measured telomerase activnies (by fluorescencebased telomeric repeat amplification protocol) with the biopsy samples. Furthem~ore, a rebopsy was performed at one week atier therapy when we diagnosed the complete necrosis using 3-phase computed tomography (CT) We then compared our findings with those of 18 HCC cases treated by PEL RESULTS: The histological tlndings showed complete necrosis in all cases of the PEI group, but we did not acquire complete necrosis in many cases of the RFA group. Before either therapy, there were no sigmticant differences in telomerase activities ni the two groups But after therapy, the telomerase actMties in all cases of the PEI group became inactive; on tire other hand, SEX cases of tetomerase activities were observed in the RFA gkoup Within a few months, we were able to identify" by CT focal recurrences in two out of the sgx cases CONCLUSIONS: Our msuhs suggest that CT alone was not sensitive enough tbr judging tumor necrosis Howcver measurement of telomerase activity appeared useful fur assessment of the efficacy of RFA Based upon our histological findings and measurements telomerase activity with biopsy samples, the necrosis effectiveness of RFA tbempy on HCC may not be superior to PET

F-antigen is a liver-specific antigen detected with antibody, raised in allogeneic (CBA) mice, to BALB/c mouse liver extract. The authors have confirmed the hepatic specificity of this antigen by showing it to be absent in extracts of extrahepatic organs of mouse and human origin. It is present in liver extracts of guinea pigs, rats, and rabbits, as well as in liver extracts from mouse and human sources. The antigen was present in the circulation of rabbits with acute carbon tetrachloride-induced hepatocellular injury. It was also demonstrated in the sera of 3 of 8 patients with acute hepatitis B antigen-positive hepatitis and in 1 of 4 patients with chronic active hepatitis. It was absent from the sera of 121 other patients with a variety of hepatic and nonhepatic diseases, and from the sera of 20 healthy subjects. The antigen is immunologically distinct from hepatitis B antigen, from the liver-specific lipoprotein antigen LP-2 of Meyer zum Buschenfeld, and from each of 15 individual human serum proteins tested.