Hepatitis C virus viral load after conversion from tacrolimus to cyclosporine in liver transplant patients: a pilot study.
We assessed whether conversion from tacrolimus (TAC) to cyclosporine (CsA) was associated with a reduction in hepatitis C virus (HCV) viral load among HCV-positive liver transplant (OLT) patients.


METHODS
Nine OLT patients with recurrent HCV have TAC and prednisone immunosuppression. None received any HCV antiviral therapy. After the last intake of TAC, the patients underwent a 12-hour area under the curve (AUC(12)) measurement of both TAC and HCV viral loads. The next morning (D(0)) patients were given CsA (4 mg/kg bid). At the first intake of CsA and at 1 month (M(1)) later, the patients underwent AUC(12) for CsA and HCV viral loads. Biological data, including aspartate (AST) and alanine (ALT) aminotransferase, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), and bilirubin levels, were collected during AUC(12), and at M(1) and M(3).


RESULTS
With respect to liver enzymes (AST, ALT, GGT), there was no significant difference between D(0), M(1), and M(3). Conversely, there was a significant decrease in AP between D(0) and M(3) (P = .02), and a significant increase in total bilirubin between D(0) and M(1) (P = .04), and between D(0) and M(3) (P = .01). HCV viral load significantly increased by M(3) (P = .01). At no time (D(0), M(1)) was there any correlation between the AUC(12) of TAC or CsA, and between AUC(12) HCV viral load.


CONCLUSIONS
This pilot study found no acute or chronic anti-HCV effects from CsA that were evident within 12 hours after CsA administrations or beyond 1 month of CsA therapy, respectively.
Guitard
J
J
Department of Nephrology, Dialysis, and Multiorgan Transplant Unit, CHU Rangueil, 1 avenue Jean Poulhès, 31059 Toulouse, France.
Sandres-Sauné
K
K
Kamar
N
N
Ribes
D
D
Faguer
S
S
Esposito
L
L
Lavit
M
M
Muscari
F
F
Péron
J M
JM
Lavayssière
L
L
Durand
D
D
Rostaing
L
L
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D016572:Cyclosporine / Q000097:blood / Q000627:therapeutic use*; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology*; D008875:Middle Aged; D010865:Pilot Projects; D011241:Prednisone / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood*; D016559:Tacrolimus / Q000097:blood / Q000627:therapeutic use*; D019562:Viral Load
D007166:Immunosuppressive Agents; D012367:RNA, Viral; D016572:Cyclosporine; D000469:Alkaline Phosphatase; D011241:Prednisone; D016559:Tacrolimus