Hepatitis C recurrence after liver transplantation: Viral and histologic response to full-dose PEG-interferon and ribavirin
| Autor: | C. Barrios, C. Blesa, José María Moreno-Planas, A. Moreno-Zamora, E. Oton, A. Moreno, Valentín Cuervas-Mons, M. Garcia-Gonzalez, E. Boullosa‐Graña, S. Garcia-Garzon, Rafael Bárcena, M. L. Mateos, E. E. Rubio‐Gonzalez |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis Adolescent Hepatitis C virus medicine.medical_treatment Biopsy Hepacivirus Neutropenia Liver transplantation Interferon alpha-2 medicine.disease_cause Gastroenterology Antiviral Agents Polyethylene Glycols chemistry.chemical_compound Recurrence Internal medicine Ribavirin medicine Immunology and Allergy Humans Transplantation Homologous Pharmacology (medical) Aged Retrospective Studies Transplantation business.industry Interferon-alpha Hepatitis C Middle Aged medicine.disease Recombinant Proteins Surgery Liver Transplantation Treatment Outcome chemistry RNA Viral Female business Viral load Follow-Up Studies |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 6(10) |
| ISSN: | 1600-6135 |
| Popis: | Hepatitis C recurrence after liver transplantation (LT) is universal, and frequently leads to cirrhosis and death. The aim of our study was to assess the efficacy and safety of 48-weeks of full-dose peg-interferon-alpha-2a (n = 4) or alpha-2b (n = 51) plus ribavirin (11 mg/kg/day) in a multicentric cohort of 55 patientsor =12 months after LT. All subjects had histologically proven HCV recurrence, excluding severe cholestatic recurrence. Mean age was 54.3 +/- 9.7, 77% male, 90.9% genotype 1, 32.7% cirrhotics. All but 5 patients received monotherapy with tacrolimus (54.5%), cyclosporine (30.7%) or mycophenolate mofetil (5.5%). The rates of end-of-treatment response and sustained virological response (SVR) were 66.7% and 43.6%, respectively. Low baseline HCV-RNA (p = 0.005) and a length from LT to therapy between 2-4 years (p = 0.011) were predictors of SVR. The lack of achieving a viral load decreaseor =1-log10 at week 4 and/or 2-log10 at week 12 was 100% predictive of failure. The most frequent side effects were neutropenia (76,4%), anemia (60%) and infectious complications (30.9%). Toxicity led to peg-interferon withdrawal in 16 (29%) subjects. In 15 patients with post-treatment biopsy, the histological activity index was significantly improved (p = 0.006), whereas fibrosis did not change (p = 0.14). Three patients died (cholangitis, hepatic artery thrombosis and lung cancer). In conclusion, HCV therapy after LT was very effective, although it led to a significant rate of toxicity. |
| Databáze: | OpenAIRE |
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