Response to antiviral therapy in liver transplant recipients with recurrent hepatitis C viral infection: a single center experience

被引:11
作者
Jain, Ashok [1 ]
Sharma, Rajeev [1 ]
Ryan, Charlotte
Safadjou, Saman [1 ]
Kashyap, Randeep [1 ]
Mantry, Parvez [2 ]
Maliakkal, Benedict [3 ]
Orloff, Mark [1 ]
机构
[1] Univ Rochester, Med Ctr, Dept Surg, Div Solid Organ Transplantat, Rochester, NY 14642 USA
[2] Methodist Dallas Med Ctr, Liver Inst, Dept Hepatol, Dallas, TX USA
[3] Univ Rochester, Med Ctr, Div Gastroenterol & Hepatol, Rochester, NY 14642 USA
关键词
hepatitis C virus; interferon; liver transplant; recurrence; ribavirin; viral hepatitis; SUSTAINED VIROLOGICAL RESPONSE; INTERFERON-ALPHA-2B PLUS RIBAVIRIN; OPEN-LABEL SERIES; VIRUS-INFECTION; PEGYLATED INTERFERON-ALPHA-2B; CONTROLLED TRIAL; PEGINTERFERON ALPHA-2A; COMBINATION; EFFICACY; IMPACT;
D O I
10.1111/j.1399-0012.2009.00961.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Recurrence of hepatitis C virus (HCV) in hepatic allograft is a major concern after successful liver transplant (LTx). Aim: To examine the response rate to pegylated interferon (PEG-IFN) and ribavirin in post-LTx patients with HCV recurrence. Patients and methods: Between January 2003 and September 2006, 60 patients with biopsy proven HCV recurrence (46 males and 14 females) received PEG-IFN 2a (n = 40) or IFN 2b (n = 20) with ribavirin. All patients were followed until July 2007. Results: Fourteen patients (23.3%) tolerated antiviral therapy for less than six months and 10 (16.7%) discontinued therapy between six and 11 months. PEG-IFN dose was reduced in 21 (35%) patients and ribavirin dose was reduced in 16 (26.7%) patients. Overall, 55% patients achieved end of treatment response (EOT) and 35% sustained virological response (SVR). Mean Hepatitis Activity Index and Fibrosis Score pre-therapy was 5.8 +/- 1.9 and 1.7 +/- 1.3 and post-therapy, it was 4.4 +/- 2.1 and 2.4 +/- 1.6, respectively. Overall, three yr patient and graft survival was 73.9% and 69.2%, respectively. The patients with SVR had significantly lower viral load compared with other groups (p = 0.028). Conclusion: PEG-IFN and ribavirin therapy achieved 55% EOT and 35% SVR; 60% patients tolerated therapy. Biochemical response was observed in all groups of patients irrespective of virological response.
引用
收藏
页码:104 / 111
页数:8
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