BACKGROUND: Hepatitis C virus (HCV) recurrence after liver transplantation (LT) is universal and tends to be more aggressive. Data on post-transplant HCV genotype 4 treatment is scarce. The aim of this study is to assess the safety and efficacy of pegylated interferon alpha-2a (PEG-IFN) in combination with ribavirin in the treatment of recurrent HCV genotype 4 after LT. METHODS: Twenty-five patients infected with HCV genotype 4 were treated with PEG-IFN alpha-2a at a dose of 180 μg/week in addition to 800 mg/day of ribavirin (the dose was adjusted within the tolerated range of 400-1,200 mg). Pretreatment liver biopsies were obtained from all patients. Biochemical and virological markers were assessed before, during, and after treatment. RESULTS: Twenty-two patients (88%) achieved an early virological response (EVR) (12 patients tested negative for HCV-RNA). Fifteen (60%) and 14 patients (56%) achieved an end of treatment virological response (ETVR) and a sustained virological response (SVR), respectively. Five patients had advanced pretreatment liver fibrosis. Pretreatment ALT was elevated in 24 patients (96%). The most common adverse effects were flu-like symptoms and cytopenia. Eighteen patients (72%) required erythropoietin alpha and/or granulocyte-colony stimulating factor as a supportive measure. One patient developed severe rejection complicated by sepsis, renal failure, and death. Other adverse effects included depression, mild rejection, impotence, itching, and vitiligo. CONCLUSIONS: Post-transplant treatment with pegylated interferon alpha-2a and ribavirin achieved SVR in 56% of liver transplant recipients with chronic HCV genotype 4 infection. The combination was relatively safe and exhibited a low rate of treatment withdrawal.
BACKGROUND:Hepatitis C virus (HCV) recurrence after liver transplantation (LT) is universal and tends to be more aggressive. Data on post-transplant HCV genotype 4 treatment is scarce. The aim of this study is to assess the safety and efficacy of pegylated interferon alpha-2a (PEG-IFN) in combination with ribavirin in the treatment of recurrent HCV genotype 4 after LT. METHODS: Twenty-five patients infected with HCV genotype 4 were treated with PEG-IFN alpha-2a at a dose of 180 μg/week in addition to 800 mg/day of ribavirin (the dose was adjusted within the tolerated range of 400-1,200 mg). Pretreatment liver biopsies were obtained from all patients. Biochemical and virological markers were assessed before, during, and after treatment. RESULTS: Twenty-two patients (88%) achieved an early virological response (EVR) (12 patients tested negative for HCV-RNA). Fifteen (60%) and 14 patients (56%) achieved an end of treatment virological response (ETVR) and a sustained virological response (SVR), respectively. Five patients had advanced pretreatment liver fibrosis. Pretreatment ALT was elevated in 24 patients (96%). The most common adverse effects were flu-like symptoms and cytopenia. Eighteen patients (72%) required erythropoietin alpha and/or granulocyte-colony stimulating factor as a supportive measure. One patient developed severe rejection complicated by sepsis, renal failure, and death. Other adverse effects included depression, mild rejection, impotence, itching, and vitiligo. CONCLUSIONS: Post-transplant treatment with pegylated interferon alpha-2a and ribavirin achieved SVR in 56% of liver transplant recipients with chronic HCV genotype 4 infection. The combination was relatively safe and exhibited a low rate of treatment withdrawal.
Authors: M Prieto; M Berenguer; J M Rayón; J Córdoba; L Argüello; D Carrasco; A García-Herola; V Olaso; M De Juan; M Gobernado; J Mir; J Berenguer Journal: Hepatology Date: 1999-01 Impact factor: 17.425
Authors: M E De Vera; G A Smallwood; K Rosado; L Davis; E Martinez; S Sharma; A C Stieber; T G Heffron Journal: Transplantation Date: 2001-03-15 Impact factor: 4.939
Authors: Roberto J Firpi; Manal F Abdelmalek; Consuelo Soldevila-Pico; Alan Reed; Alan Hemming; Richard Howard; William Van Der Werf; Gregory Lauwers; Chen Liu; James M Crawford; Gary L Davis; David R Nelson Journal: Liver Transpl Date: 2002-11 Impact factor: 5.799
Authors: S Dinges; I Morard; M Heim; J-F Dufour; B Müllhaupt; E Giostra; P-A Clavien; G Mentha; F Negro Journal: Transpl Infect Dis Date: 2008-12-03 Impact factor: 2.228
Authors: E Xirouchakis; C Triantos; P Manousou; A Sigalas; V Calvaruso; A Corbani; G Leandro; D Patch; A Burroughs Journal: J Viral Hepat Date: 2008-07-28 Impact factor: 3.728
Authors: Hiroyuki Sugo; Glenda A Balderson; Darrell H G Crawford; Jonathan Fawcett; Stephen V Lynch; Russell W Strong; Shunji Futagawa Journal: Surg Today Date: 2003 Impact factor: 2.549
Authors: E J Gane; B C Portmann; N V Naoumov; H M Smith; J A Underhill; P T Donaldson; G Maertens; R Williams Journal: N Engl J Med Date: 1996-03-28 Impact factor: 91.245