インターフェロンの長期投与により肝線維化の著明な改善を認め，肝癌の再発が長期間抑制されているC型慢性肝炎の1例 Long-term interferon therapies improved hepatic fibrosis and prevented the recurrence of hepatocellular carcinoma in a patient with hepatitis C virus infection

症例は27歳の男性．生後2カ月でB型肝炎ウイルスの母子感染によってinfantile fulminant hepatitisを発症し，その際の治療でC型肝炎ウイルスに感染した．2歳時よりC型肝炎に対し間欠的にインターフェロン（IFN）治療と肝庇護療法を受けた．8歳時には肝細胞癌を発症し，肝部分切除術を施行された．以後も間欠的にIFN治療を受け，ウイルス学的著効は得られていないにもかかわらず，長期間のIFN治療により組織学的に肝線維化の改善を認め，肝癌術後から約19年間が経過した現在も再発も認めていない．C型慢性肝炎においては，慢性炎症による肝細胞壊死と再生が繰り返されることで肝臓の線維化が進展し，肝癌の発生率が増加する．そのため発癌予防には肝線維化の進展を防ぐことが重要であり，本症例のように長期的なIFN治療は肝線維化の改善及び肝癌再発抑制に対して有用と考えられる．

We report a 27-year-old male patient received long-term interferon (IFN) therapies for hepatitis C virus (HCV) infection. He had suffered from infantile fulminant hepatitis due to hepatitis B virus. He was infected with HCV by the treatment for the hepatitis. He was histologically diagnosed as having liver cirrhosis and received interferon therapy at the age of 2. He was diagnosed as hepatocellular carcinoma (HCC) at the age of 8, received surgical treatment and continued IFN therapy at the age of 23. He received liver biopsy at the age of 25; the fibrosis had improved even though the HCV had not been cleared. There is no recurrence of HCC during this period. Chronic inflammation plays an important role in liver fibrosis in patients with HCV infection. If liver fibrosis progresses, the incidence of HCC increases. Long-term interferon treatment is useful to improve the fibrosis and reduce the incidence of HCC.