BACKGROUND/AIMS: HCV infection recurs almost in all HCV-positive patients receiving liver transplantation and carries a poor prognosis. Aim of this study was to analyze efficacy and effect on survival of antiviral therapy in this clinical setting. METHODS: Pegylated-interferon alpha-2b and ribavirin were administered at a dose of 1 microg/kg of bwt weekly and 600-800 mg/day. Planned duration of treatment was 24 or 48 weeks according to HCV genotype. Patients who failed to respond at week 24 were considered as non-responders. RESULTS: 61 patients were enrolled. According to intention-to-treat analysis, 44 (72%) patients were considered as treatment failure (31 non-responders, 4 relapsers, 9 dropout). Sustained virological response was achieved in 17 cases (28%). Genotype 2, higher doses of antivirals and absence of histological cirrhosis were predictors of sustained virological response. In the follow up, patients with sustained virological response had a significantly lower mortality compared to patients with treatment failure (chi2=6.9; P<0.01). CONCLUSIONS: Response rate to antiviral therapy in HCV reinfection after liver transplantation is higher if a full dose of antiviral drugs is administered and if treatment starts before histological cirrhosis has developed. Sustained virological response improves patient survival.
BACKGROUND/AIMS: HCV infection recurs almost in all HCV-positive patients receiving liver transplantation and carries a poor prognosis. Aim of this study was to analyze efficacy and effect on survival of antiviral therapy in this clinical setting. METHODS: Pegylated-interferon alpha-2b and ribavirin were administered at a dose of 1 microg/kg of bwt weekly and 600-800 mg/day. Planned duration of treatment was 24 or 48 weeks according to HCV genotype. Patients who failed to respond at week 24 were considered as non-responders. RESULTS: 61 patients were enrolled. According to intention-to-treat analysis, 44 (72%) patients were considered as treatment failure (31 non-responders, 4 relapsers, 9 dropout). Sustained virological response was achieved in 17 cases (28%). Genotype 2, higher doses of antivirals and absence of histological cirrhosis were predictors of sustained virological response. In the follow up, patients with sustained virological response had a significantly lower mortality compared to patients with treatment failure (chi2=6.9; P<0.01). CONCLUSIONS: Response rate to antiviral therapy in HCV reinfection after liver transplantation is higher if a full dose of antiviral drugs is administered and if treatment starts before histological cirrhosis has developed. Sustained virological response improves patient survival.
Authors: Varun Saxena; Jennifer C Lai; Jacqueline G O'Leary; Elizabeth C Verna; Robert S Brown; R Todd Stravitz; James F Trotter; Kartik Krishnan; Norah A Terrault Journal: Liver Transpl Date: 2012-05 Impact factor: 5.799
Authors: Robert S Brown; Jacqueline G O'Leary; K Rajender Reddy; Alexander Kuo; Giuseppe J Morelli; James R Burton; R Todd Stravitz; Christine Durand; Adrian M Di Bisceglie; Paul Kwo; Catherine T Frenette; Thomas G Stewart; David R Nelson; Michael W Fried; Norah A Terrault Journal: Liver Transpl Date: 2016-01 Impact factor: 5.799
Authors: Hatim Mudawi; Ahmed Helmy; Yasser Kamel; Mohammed Al Saghier; Mohammed Al Sofayan; Mohammed Al Sebayel; Hatem Khalaf; Hamad Al Bahili; Yasser Al Shiek; Khalil Alawi; Ahmed Aljedai; Hazem Mohamed; Waleed Al Hamoudi; Ayman Abdo Journal: Ann Saudi Med Date: 2009 Mar-Apr Impact factor: 1.526