[Recurrent hepatitis C after liver transplantation: Erythropoietin allows maintenance of antiviral treatment].
BACKGROUND
Hepatitis C recurs on grafts after liver transplantation and cirrhosis develops more rapidly than in patients without transplants. It is thus essential to develop effective antiviral treatments for these patients. Prolonged virologic response rate after treatment by pegylated interferon and ribavirin of recurrent HVC is limited, because so many patients stop or reduce the treatment because, in particular, of profound anemia. Administration of erythropoietin can enable these patients to continue treatment and thus improve viral eradication.


METHODS
We report three cases where antiviral treatment continued although the clinical data would, in the absence of erythropoietin, have led us to interrupt it and where prolonged virologic response was obtained.


CONCLUSIONS
These data suggest that the onset of anemia largely explains the failure of previous trials, although response to treatment is at least as good as in non-transplanted patients, despite immunosuppressive treatment.
Service de chirurgie, Hôpital Cochin, AP-HP, Paris.
Yana
Y
Boyanova
Alcindo
A
Pissaia
Filoména
F
Conti
Olivier
O
Soubrane
Yvon
Y
Calmus
D000740:Anemia / Q000209:etiology / Q000517:prevention & control; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D006526:Hepatitis C / Q000188:drug therapy* / Q000209:etiology* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011092:Polyethylene Glycols; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b