Predictive factors of lack of response to antiviral therapy among in patients with recurrent hepatitis C after liver transplantation

Transplant Proc. 2010 May;42(4):1223-5. doi: 10.1016/j.transproceed.2010.03.052.

Abstract

The current therapy for hepatitis C recurrence after liver transplantation OLT is based on interferon (IFN) and ribavirin (RBV) in monotherapy or combination. The rate of sustained virological response (SVR) varies between 10% and 45%. We have retrospectively analyzed factors that could predict SVR after antiviral therapy. We analyzed 42 patients who completed a cycle of therapy with natural or pegylated IFN plus RBV. There were 15 (35.7%) patients who obtained an SVR. The following factors were significantly associated with a lack of SVR: donor age >or=50 years (P = .046); donor body mass index (BMI) > 27 (P = .016); genotype 1 versus 2 to 3 (P = 0.010), aspartate transferase (AST) before therapy >or= 140 U/L (P = .046), alanine transferase before therapy >or= 280 U/L (P = .055), use of natural IFN versus pegylated IFN (P = .016). The only factors remaining after multivariate analysis were: donor BMI, AST before therapy and genotype. Our data confirmed that genotype 1 was associated with poorer outcomes; other additional parameters can influence the response to antiviral therapy.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antiviral Agents / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Body Mass Index
  • Genotype
  • Hepatitis C / drug therapy*
  • Hepatitis C / genetics
  • Hepatitis C / surgery
  • Humans
  • Liver Transplantation / physiology*
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • RNA, Viral / analysis
  • Retrospective Studies
  • Tissue Donors / statistics & numerical data
  • Treatment Failure

Substances

  • Antiviral Agents
  • RNA, Viral
  • Aspartate Aminotransferases
  • Alanine Transaminase