Long-term combination of interferon alfa-2b and ribavirin for hepatitis C recurrence in liver transplant patients.
The purpose of this study was to evaluate the feasibility, tolerability and efficacy of long-term combination therapy with interferon-alfa 2b (IFNalpha-2b) and ribavirin (Rb) for recurrent hepatitis C after liver transplantation. Fifteen patients with histologically confirmed hepatitis C after liver transplantation were treated. After a basic course of 12 months (IFNalpha-2b 3 MU/3 times a week; Rb 3 x 200 mg/day), patients achieving clearance of viremia underwent maintenance therapy with ribavirin (3 x 200 mg/day). Patients without virological response continuously received combination therapy. Levels of HCV RNA, aminotransferases and bilirubin were followed. Therapy led to a significant decline of transaminases and bilirubin in all patients (p < 0.05). Sixty-four per cent of patients had clearance of viremia after 12 months. Sustained virolo gical response was 88%. In patients without virological response, continuation of combination therapy prevented another biochemical relapse of hepatitis. Treatment was accompanied by severe hematological side-effects, requiring medical support in a majority of patients. In two patients (13.5%), therapy finally had to be withdrawn because of major hematological disorders. These results indicate that long-term combination therapy with IFNalpha-2b and Rb is effective in the treatment of recurrent hepatitis C and in preventing further relapse of disease after liver transplantation, but side-effects may require cessation of therapy.
Kornberg
A
A
Department of General and Visceral Surgery, Friedrich-Schiller-University, Jena, Germany. Arno.Kornberg@med.uni-jena.de
Hommann
M
M
Tannapfel
A
A
Wagner
T
T
Grube
T
T
Schotte
U
U
Voigt
R
R
Scheele
J
J
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D011994:Recombinant Proteins; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D014766:Viremia / Q000188:drug therapy
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin