Interfaces are made to match the C++ vtable. Using them from C, for example, is somewhat of a hassle. (Not to say anything about IDL…)
The C wrappers generated by MIDL are also fairly similar to raw C++, compare (where pUnk is an IUnk *):
pUnk->Something(&bA);
with... IUnk_Something(pUnk, &bA);
which expands to something like this: pUnk->lpVtbl->Something(pUnk, &bA);