BACKGROUND: Cyclosporine has antiviral activity in vitro against hepatitis C (HCV). We performed a pilot study to prospectively determine the antiviral effect of cyclosporine during therapy with PEGalfa-2a and ribavirin in liver transplant recipients with recurrent HCV infection. METHODS: Patients with HCV recurrence (Ishak Fibrosis Stage > or = 2) were enrolled for 2 years at the University of Florida. Thirty-eight patients were randomized to continued tacrolimus or switched to cyclosporine. Both groups received PEGalfa-2a and ribavirin. RESULTS: Twenty patients received tacrolimus and 18 cyclosporine, with a mean age of 53. Eighty-two percent were men, 84% Caucasian, and 90% genotype 1. In patients switched from tacrolimus to cyclosporine, HCVRNA levels decreased by a mean of 0.39 million IU/ml during the 1 month prior to initiating PEG/RBV. Sustained viral response for cyclosporine was higher than in patients on tacrolimus receiving PEG/RBV therapy. CONCLUSIONS: This randomized controlled pilot study is the first in vivo study evaluating cyclosporine versus tacrolimus in liver transplant recipients undergoing antiviral therapy. Change from tacrolimus to cyclosporine led to a modest HCV RNA drop and appeared to enhance the antiviral response of PEG/RBV. A larger randomized study is necessary to see if cyclosporine offers any advantage over tacrolimus.
BACKGROUND: Cyclosporine has antiviral activity in vitro against hepatitis C (HCV). We performed a pilot study to prospectively determine the antiviral effect of cyclosporine during therapy with PEGalfa-2a and ribavirin in liver transplant recipients with recurrent HCV infection. METHODS: Patients with HCV recurrence (Ishak Fibrosis Stage > or = 2) were enrolled for 2 years at the University of Florida. Thirty-eight patients were randomized to continued tacrolimus or switched to cyclosporine. Both groups received PEGalfa-2a and ribavirin. RESULTS: Twenty patients received tacrolimus and 18 cyclosporine, with a mean age of 53. Eighty-two percent were men, 84% Caucasian, and 90% genotype 1. In patients switched from tacrolimus to cyclosporine, HCVRNA levels decreased by a mean of 0.39 million IU/ml during the 1 month prior to initiating PEG/RBV. Sustained viral response for cyclosporine was higher than in patients on tacrolimus receiving PEG/RBV therapy. CONCLUSIONS: This randomized controlled pilot study is the first in vivo study evaluating cyclosporine versus tacrolimus in liver transplant recipients undergoing antiviral therapy. Change from tacrolimus to cyclosporine led to a modest HCV RNA drop and appeared to enhance the antiviral response of PEG/RBV. A larger randomized study is necessary to see if cyclosporine offers any advantage over tacrolimus.
Authors: Naga Chalasani; Cosme Manzarbeitia; Peter Ferenci; Wolfgang Vogel; Robert J Fontana; Michael Voigt; Caroline Riely; Paul Martin; Lewis Teperman; James Jiao; Juan Carlos Lopez-Talavera Journal: Hepatology Date: 2005-02 Impact factor: 17.425
Authors: Roberto J Firpi; Haizhen Zhu; Giuseppe Morelli; Manal F Abdelmalek; Consuelo Soldevila-Pico; Victor I Machicao; Roniel Cabrera; Alan I Reed; Chen Liu; David R Nelson Journal: Liver Transpl Date: 2006-01 Impact factor: 5.799
Authors: S C Rayhill; R Barbeito; D Katz; M Voigt; D Labrecque; P Kirby; R Miller; A Stolpen; Y Wu; W Schmidt Journal: Transplant Proc Date: 2006-12 Impact factor: 1.066
Authors: Paul Martin; Ronald W Busuttil; Robert M Goldstein; Jeffrey S Crippin; Goran B Klintmalm; William E Fitzsimmons; Carol Uleman Journal: Liver Transpl Date: 2004-10 Impact factor: 5.799
Authors: Miguel Jiménez-Pérez; Rocío González-Grande; Francisco Javier Rando-Muñoz Journal: World J Gastroenterol Date: 2014-11-28 Impact factor: 5.742
Authors: James R Burton; Jacqueline G O'Leary; Elizabeth C Verna; Varun Saxena; Jennifer L Dodge; Richard T Stravitz; Joshua Levitsky; James F Trotter; Gregory T Everson; Robert S Brown; Norah A Terrault Journal: J Hepatol Date: 2014-05-05 Impact factor: 25.083
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
Authors: Manuel Rodríguez-Perálvarez; Marta Guerrero-Misas; Douglas Thorburn; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-03-31