Long-term antiviral treatment for recurrent hepatitis C after liver transplantation

Dig Liver Dis. 2012 Oct;44(10):861-7. doi: 10.1016/j.dld.2012.06.013. Epub 2012 Jul 21.

Abstract

Background and aims: The management of patients treated for hepatitis C recurrence after liver transplantation and not achieving virological response following treatment with interferon plus ribavirin is controversial.

Methods: A retrospective analysis of the outcomes of 70 patients non-responders to antiviral treatment after liver transplantation was performed. Twenty-one patients (30.0%; Group A) were treated for ≤ 12 months and 49 (70.0%; Group B) for more than 12 months.

Results: The 2 groups were comparable for main demographic, clinical and pathological variables. Median duration of antiviral treatment was 8.2 months in Group A and 33.4 months in Group B. No patient achieved a complete virological response. The 5-year patient hepatitis C-related survival rate was 49.2% in Group A and 88.3% in Group B (P=0.002), while the 5-year graft survival rate was 49.2% in Group A and 85.9% in Group B (P=0.007). The median yearly fibrosis progression rate was 1.21 per year in Group A and 0.40 per year in Group B (P=0.001).

Conclusions: Prolonged antiviral treatment showed an overall beneficial effect in transplanted patients with a recurrent hepatitis C infection and not responding to conventional therapy. The treatment should be continued as long as it is permitted, in order to improve clinical and histological outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Hepatitis C / diagnosis
  • Hepatitis C / drug therapy*
  • Hepatitis C / mortality
  • Hepatitis C / surgery
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Liver / pathology
  • Liver Transplantation*
  • Male
  • Middle Aged
  • RNA, Viral
  • Recombinant Proteins / therapeutic use
  • Recurrence
  • Retrospective Studies
  • Ribavirin / therapeutic use*
  • Survival Rate

Substances

  • Antiviral Agents
  • Immunosuppressive Agents
  • Interferon alpha-2
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins
  • Ribavirin