Journal article
Combination of interferon alfa-2b and ribavirin in liver transplant recipients with histological recurrent hepatitis C
Liver transplantation, Vol.8(11), pp.1000-1006
11/01/2002
DOI: 10.1053/jlts.2002.34968
PMID: 12424712
Abstract
Recurrent hepatitis C virus (HCV) infection is an important cause of fibrosis and cirrhosis after liver transplantation (LT), with histological recurrence developing in at least 50% of patients within the first year. The aim of this study is to assess the safety and efficacy of interferon alfa-2b plus ribavirin in treating histological recurrent HCV after LT. Since 1998, patients with HCV with significant histological recurrence (fibrosis >/= 3 and/or histological activity index >/= 5) or progressive cholestatic disease after LT were treated with interferon alfa-2b (3 million units subcutaneously three times weekly) plus ribavirin (800 to 1,000 mg/d) for 12 months. Immunosuppression was tapered to cyclosporine/FK506 monotherapy. HCV RNA was assessed at entry, week 24, end of treatment, and 6 months after therapy. The primary end point was loss of HCV RNA 6 months after therapy, whereas the secondary end point was histological response. Fifty-four patients met criteria for treatment and have completed follow-up. Patients were mainly men (71% men; mean age, 51 +/- 5 years) with genotype 1 infection (88%) and high viral load (mean HCV RNA, 38 +/- 9 mEq/mL). Dose modification was required in 72% of patients because of cytopenia or side effects. Intent-to-treat analysis showed that serum HCV RNA was undetectable in 19 patients (35%) week 24, 21 patients (38%) week 48, and 16 patients (30%) at the 6-month follow-up. Paired liver biopsy results (before and within 6 months after treatment) were available for 35 patients. Patients who achieved viral eradication had no significant progression of fibrosis after 1 year of therapy. In summary, combination therapy is a reasonable antiviral option for recurrent HCV infection for established post-LT hepatitis and appears to prevent histological progression of disease if viral eradication is successful.
Details
- Title: Subtitle
- Combination of interferon alfa-2b and ribavirin in liver transplant recipients with histological recurrent hepatitis C
- Creators
- Roberto J Firpi - Department of Medicine, Section of Hepatobiliary Diseases, Gainesville, FLManal F Abdelmalek - Department of Medicine, Section of Hepatobiliary Diseases, Gainesville, FLConsuelo Soldevila-Pico - Department of Medicine, Section of Hepatobiliary Diseases, Gainesville, FLAlan Reed - University of FloridaAlan Hemming - University of FloridaRichard Howard - University of FloridaWilliam Van Der Werf - University of FloridaGregory Lauwers - University of FloridaChen Liu - University of FloridaJames M Crawford - University of FloridaGary L Davis - Department of Medicine, Section of Hepatobiliary Diseases, Gainesville, FLDavid R Nelson - Department of Medicine, Section of Hepatobiliary Diseases, Gainesville, FL
- Resource Type
- Journal article
- Publication Details
- Liver transplantation, Vol.8(11), pp.1000-1006
- DOI
- 10.1053/jlts.2002.34968
- PMID
- 12424712
- ISSN
- 1527-6465
- eISSN
- 1527-6473
- Language
- English
- Date published
- 11/01/2002
- Academic Unit
- Accounting; Surgery
- Record Identifier
- 9984322807602771
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