title: Ribavirin/interferon-alpha sequential treatment of recurrent hepatitis C after liver transplantation.
abstract: Hepatitis C virus (HCV) infection invariably recurs after liver transplantation (LT), and sequels of chronic hepatitis of the graft are a significant cause of morbidity and mortality. In an uncontrolled trial, 31 patients with histologically confirmed hepatitis C after LT received, sequentially, ribavirin (10 mg/kg body weight q.d.) for 12 weeks, followed by ribavirin at the same dose q.d. plus interferon-alpha (IFN-alpha) [3 million units three times a week (3 MU TIW)] for another 48 weeks. Based on an intent-to-treat analysis, the percentages of patients with undetectable HCV RNA in their serum were 0%, 38.7% and 45.2% after 12, 36 and 60 weeks of therapy, respectively. A sustained virological response, as defined by undetectable serum HCV RNA 24 weeks after the end of treatment, was observed in 9/31 patients (29%). Sustained responders had a significant improvement of their liver inflammatory activity score (P=0.025), but not of their liver fibrosis score. The chances of sustained virological response correlated with the length of treatment, but not with the HCV genotype or baseline HCV RNA level. In conclusion, patients with recurrent hepatitis C after LT might benefit from ribavirin/IFN-alpha therapy, provided that the treatment is tolerated for a sufficient duration of time.
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital of Geneva, rue Micheli-du-Crest 24, 1211 Geneva, Switzerland.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Giostra
authors.forename: Gerd A
authors.initials: GA
authors.lastname: Kullak-Ublick
authors.forename: Walter
authors.initials: W
authors.lastname: Keller
authors.forename: Ronald
authors.initials: R
authors.lastname: Fried
authors.forename: Claire
authors.initials: C
authors.lastname: Vanlemmens
authors.forename: Stephan
authors.initials: S
authors.lastname: Kraehenbuhl
authors.forename: Sandrine
authors.initials: S
authors.lastname: Locher
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Egger
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
authors.forename: Antoine
authors.initials: A
authors.lastname: Hadengue
authors.forename: Gilles
authors.initials: G
authors.lastname: Mentha
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Francesco
authors.initials: F
authors.lastname: Negro
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000188:drug therapy* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000517:prevention & control; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin