title: Sustained virological response to antiviral therapy reduces mortality in HCV reinfection after liver transplantation.
abstract: OBJECTIVE
  HCV infection recurs almost in all HCV-positive patients receiving liver transplantation and carries a poor prognosis. Aim of this study was to analyze efficacy and effect on survival of antiviral therapy in this clinical setting.
  
  
  METHODS
  Pegylated-interferon alpha-2b and ribavirin were administered at a dose of 1 microg/kg of bwt weekly and 600-800 mg/day. Planned duration of treatment was 24 or 48 weeks according to HCV genotype. Patients who failed to respond at week 24 were considered as non-responders.
  
  
  RESULTS
  61 patients were enrolled. According to intention-to-treat analysis, 44 (72%) patients were considered as treatment failure (31 non-responders, 4 relapsers, 9 dropout). Sustained virological response was achieved in 17 cases (28%). Genotype 2, higher doses of antivirals and absence of histological cirrhosis were predictors of sustained virological response. In the follow up, patients with sustained virological response had a significantly lower mortality compared to patients with treatment failure (chi2=6.9; P<0.01).
  
  
  CONCLUSIONS
  Response rate to antiviral therapy in HCV reinfection after liver transplantation is higher if a full dose of antiviral drugs is administered and if treatment starts before histological cirrhosis has developed. Sustained virological response improves patient survival.
authors.affiliation: Unità Operativa Complessa di Epatologia, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli, Italy.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Picciotto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tritto
authors.forename: Alfonso Galeota
authors.initials: AG
authors.lastname: Lanza
authors.forename: Luigi
authors.initials: L
authors.lastname: Addario
authors.forename: Massimo
authors.initials: M
authors.lastname: De Luca
authors.forename: Giovan Giuseppe
authors.initials: GG
authors.lastname: Di Costanzo
authors.forename: Filippo
authors.initials: F
authors.lastname: Lampasi
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Tartaglione
authors.forename: Giuseppina Marino
authors.initials: GM
authors.lastname: Marsilia
authors.forename: Fulvio
authors.initials: F
authors.lastname: Calise
authors.forename: Oreste
authors.initials: O
authors.lastname: Cuomo
authors.forename: Antonio
authors.initials: A
authors.lastname: Ascione
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology; D006526:Hepatitis C / Q000188:drug therapy* / Q000401:mortality* / Q000517:prevention & control; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D055502:Secondary Prevention; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a