Lluis Castells1, Antoni Rimola2, Christian Manzardo3, Andrés Valdivieso4, José Luis Montero5, Rafael Barcena6, Manuel Abradelo7, Xavier Xiol8, Victoria Aguilera9, Magdalena Salcedo10, Manuel Rodriguez11, Carmen Bernal12, Francisco Suarez13, Antonio Antela14, Sergio Olivares7, Santos Del Campo6, Montserrat Laguno3, José R Fernandez4, Gloria de la Rosa15, Fernando Agüero3, Iñaki Perez3, Juan González-García16, Juan I Esteban-Mur1, Jose M Miro17. 1. Hospital Vall d'Hebrón, Universitat Autónoma de Barcelona, Barcelona, Spain; CIBEREHD, Barcelona, Spain. 2. CIBEREHD, Barcelona, Spain; Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. 3. Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. 4. Hospital de Cruces, University of the Basque Country, Bilbao, Spain. 5. Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. 6. Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain. 7. Hospital Universitario Doce de Octubre, Madrid, Spain. 8. Hospital de Bellvitge-IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. 9. Hospital Universitari La Fe, Valencia, Spain. 10. Hospital General Universitario Gregorio Marañón, Madrid, Spain. 11. Hospital Universitario Central de Asturias, Oviedo, Spain. 12. Hospital Universitario Virgen del Rocío, Sevilla, Spain. 13. Complejo Hospitalario Universitario, A Coruña, Spain. 14. Hospital Universitario de Santiago de Compostela, La Coruña, Spain. 15. Organización Nacional de Trasplantes, Madrid, Spain. 16. Hospital Universitario La Paz-IdiPaz, Madrid, Spain. 17. Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
Abstract
BACKGROUND & AIMS: The aim of this study was to evaluate the results of treatment with pegylated interferon and ribavirin for the recurrence of hepatitis C after liver transplantation in HCV/HIV-coinfected patients. METHODS: This was a prospective, multicentre cohort study, including 78 HCV/HIV-coinfected liver transplant patients who received treatment for recurrent hepatitis C. For comparison, we included 176 matched HCV-monoinfected patients who underwent liver transplantation during the same period of time at the same centres and were treated for recurrent hepatitis C. RESULTS: Antiviral therapy was discontinued prematurely in 56% and 39% (p = 0.016), mainly because of toxicity (22% and 11%, respectively; p=0.034). Sustained virological response (SVR) was achieved in 21% of the coinfected patients and in 36% of monoinfected patients (p = 0.013). For genotype 1, SVR rates were 10% and 33% (p = 0.002), respectively; no significant differences were observed for the other genotypes. A multivariate analysis based on the whole series identified HIV-coinfection as an independent predictor of lack of SVR (OR, 0.17; 95% CI, 0.06-0.42). Other predictors of SVR were donor age, pretreatment HCV viral load, HCV genotype, and early virological response. SVR was associated with a significant improvement in survival: 5-year survival after antiviral treatment was 79% for HCV/HIV-coinfected patients with SVR vs. 43% for those without (p = 0.02) and 92% vs. 60% in HCV-monoinfected patients (p < 0.001), respectively. CONCLUSIONS: The response to pegylated interferon and ribavirin was poorer in HCV/HIV-coinfected liver recipients, particularly those with genotype 1. However, when SVR was achieved, survival of coinfected patients increased significantly.
BACKGROUND & AIMS: The aim of this study was to evaluate the results of treatment with pegylated interferon and ribavirin for the recurrence of hepatitis C after liver transplantation in HCV/HIV-coinfectedpatients. METHODS: This was a prospective, multicentre cohort study, including 78 HCV/HIV-coinfected liver transplantpatients who received treatment for recurrent hepatitis C. For comparison, we included 176 matched HCV-monoinfected patients who underwent liver transplantation during the same period of time at the same centres and were treated for recurrent hepatitis C. RESULTS: Antiviral therapy was discontinued prematurely in 56% and 39% (p = 0.016), mainly because of toxicity (22% and 11%, respectively; p=0.034). Sustained virological response (SVR) was achieved in 21% of the coinfected patients and in 36% of monoinfected patients (p = 0.013). For genotype 1, SVR rates were 10% and 33% (p = 0.002), respectively; no significant differences were observed for the other genotypes. A multivariate analysis based on the whole series identified HIV-coinfection as an independent predictor of lack of SVR (OR, 0.17; 95% CI, 0.06-0.42). Other predictors of SVR were donor age, pretreatment HCV viral load, HCV genotype, and early virological response. SVR was associated with a significant improvement in survival: 5-year survival after antiviral treatment was 79% for HCV/HIV-coinfectedpatients with SVR vs. 43% for those without (p = 0.02) and 92% vs. 60% in HCV-monoinfected patients (p < 0.001), respectively. CONCLUSIONS: The response to pegylated interferon and ribavirin was poorer in HCV/HIV-coinfected liver recipients, particularly those with genotype 1. However, when SVR was achieved, survival of coinfected patients increased significantly.
Authors: Mattias Mandorfer; Philipp Schwabl; Sebastian Steiner; Thomas Reiberger; Markus Peck-Radosavljevic Journal: Hepatol Int Date: 2016-01-12 Impact factor: 6.047
Authors: Isabel Campos-Varela; Jennifer L Dodge; Norah A Terrault; Danielle Brandman; Jennifer C Price Journal: Am J Transplant Date: 2021-07-08 Impact factor: 9.369