BACKGROUND: To lessen the severity of recurrent hepatitis C virus (HCV) postliver transplantation (post-LT) by treating HCV patients with cirrhosis, we assessed the safety and efficacy of an escalating dose pegylated interferon (PEG-IFN)/ribavirin protocol in pre-LT patients. METHODS: Ninety patients were treated with 90 microg PEG-IFN alpha-2a and 400 mg ribavirin and advanced to 180 microg and 800 to 1200 mg, respectively, over 8 weeks. RESULTS: Mean age was 55.3 years. Thirty-four percent of patients received prior interferon treatment, 77% had genotype 1 or 4. Mean Child's score was 6.7 and model for end-stage liver disease 11.2; 49% reached full-dose PEG-IFN and 85% ribavirin, 18% required dose reduction, 33% stopped treatment because of adverse effects, 9% had deterioration of liver function, and 7% died. Follow-up of 9.6 months showed sustained virological response in 13% of patients. The rate of serious complications was 16.3% in Child's class A, 48% in B, and 100% in C (P=0.005). Serum albumin was a significant predictor for worsening liver function (P=0.007). CONCLUSIONS: Using an escalating dose regimen of PEG-IFN alpha-2a and ribavirin, we achieved only a 13% sustained virological response in HCV cirrhotic pre-LT patients with an accompanying 9% risk of worsening liver function and 7% risk of death.
BACKGROUND: To lessen the severity of recurrent hepatitis C virus (HCV) postliver transplantation (post-LT) by treating HCVpatients with cirrhosis, we assessed the safety and efficacy of an escalating dose pegylated interferon (PEG-IFN)/ribavirin protocol in pre-LT patients. METHODS: Ninety patients were treated with 90 microg PEG-IFN alpha-2a and 400 mg ribavirin and advanced to 180 microg and 800 to 1200 mg, respectively, over 8 weeks. RESULTS: Mean age was 55.3 years. Thirty-four percent of patients received prior interferon treatment, 77% had genotype 1 or 4. Mean Child's score was 6.7 and model for end-stage liver disease 11.2; 49% reached full-dose PEG-IFN and 85% ribavirin, 18% required dose reduction, 33% stopped treatment because of adverse effects, 9% had deterioration of liver function, and 7% died. Follow-up of 9.6 months showed sustained virological response in 13% of patients. The rate of serious complications was 16.3% in Child's class A, 48% in B, and 100% in C (P=0.005). Serum albumin was a significant predictor for worsening liver function (P=0.007). CONCLUSIONS: Using an escalating dose regimen of PEG-IFN alpha-2a and ribavirin, we achieved only a 13% sustained virological response in HCV cirrhotic pre-LT patients with an accompanying 9% risk of worsening liver function and 7% risk of death.
Authors: Kieron B L Lim; Hamid R Sima; M Isabel Fiel; Viktoriya Khaitova; John T Doucette; Maria Chernyiak; Jawad Ahmad; Nancy Bach; Charissa Chang; Priya Grewal; Leona Kim-Schluger; Lawrence Liu; Joseph Odin; Ponni Perumalswami; Sander S Florman; Thomas D Schiano Journal: World J Gastroenterol Date: 2015-05-28 Impact factor: 5.742
Authors: Ruben Ciria; María Pleguezuelo; Shirin Elizabeth Khorsandi; Diego Davila; Abid Suddle; Hector Vilca-Melendez; Sebastian Rufian; Manuel de la Mata; Javier Briceño; Pedro López Cillero; Nigel Heaton Journal: World J Hepatol Date: 2013-05-27