Interferon-alpha therapy for hepatitis C virus recurrence after liver transplantation: long-term response with maintenance therapy.
Interferon-alpha is currently the only available treatment for HCV hepatitis. We assessed the safety and efficacy of 6 month course of interferon therapy in 18 consecutive liver transplant recipients with recurrent HCV hepatitis and report the long-term response with maintenance interferon. Median follow-up after the institution of interferon was 24 months. Complete response was defined as normalization of both aspartate and alanine aminotransferase. Complete response after 6 months of interferon was observed in 28% (5/18); an additional 33% (6/18) of the patients were late responders. Overall, 61% (11/18) of the patients had long-term sustained normal response at a median follow-up of 24 months. Long-term sustained response was observed in 73% (8/11) of the patients who continued interferon beyond 6 months vs. 43% (3/7) in those who received 6 months of interferon. Fatigue, headache and cytopenia were the most commonly observed side-effects occurring in 39%, 22% and 28% of the patients, respectively. Discontinuation of interferon, however, was not required in any of the patients. Rejection was documented in 6% (1/18) patients receiving interferon; this incidence was not higher than rejection episodes occurring > 6 months post-transplant in other recipients transplanted during the same period and who did not receive interferon. Responders had a trend towards later recurrence of HCV hepatitis after transplantation. In conclusion; maintenance interferon was well tolerated and appeared to improve the long-term outcome in our patients; however, future studies should evaluate this in a controlled trial.
Singh
N
N
VA Medical Center, Pittsburgh, PA 15240, USA.
Gayowski
T
T
Wannstedt
C F
CF
Marino
I R
IR
Wagener
M M
MM
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006084:Graft Rejection; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012008:Recurrence; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha