Efficacy of interferon based antiviral therapy for recurrent hepatitis C in patients who received steroid free immunosuppression for liver transplantation.
BACKGROUND
In this article, we explore the virological response to two types of interferon based treatment in recurrent hepatitis C virus in liver recipients who received thymoglobulin induction.


METHODS
Fifty consecutive patients were randomized to receive PEG interferon alpha 2b (1.0 microg/kg per week), ribavirin (800 mg/d) plus amantadine (200 mg/d), or PEG interferon alpha 2b (1.0 microg/kg per week) plus ribavirin (800 mg/d). The primary endpoint was absence of hepatitis C virus RNA 6 months posttreatment. The secondary endpoint was change in fibrosis at 1 year.


RESULTS
Only 30 patients completed 1 year of treatment. In an intention to treat analysis, the sustained virological response (SVR) rate was 26% in I/R/A group and 50% in I/R group. By per protocol, the overall SVR rate was 57%. Fibrosis progression by at least one stage was noted in 37% patients. Twenty-nine percent of patients who achieved SVR had shown fibrosis progression by at least one stage whereas 46% nonresponders showed fibrosis progression (P=NS).


CONCLUSIONS
This is the first study exploring the efficacy of pegylated interferon-based antiviral treatment in patients who received a steroid-free protocol. Our data is encouraging and shows that if liver transplant recipients can tolerate treatment for 1 year there is a reasonable chance of SVR.
Nair
Satheesh
S
Division of Gastroenterology and Hepatology, Ochsner Clinic Foundation, New Orleans, LA, USA. snair@utmem.edu
Lipscomb
Jeannie
J
Eason
James
J
D000547:Amantadine / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000961:Antilymphocyte Serum; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000547:Amantadine; C512542:thymoglobulin; C417083:peginterferon alfa-2b