Predictive factors of lack of response to antiviral therapy among in patients with recurrent hepatitis C after liver transplantation.
The current therapy for hepatitis C recurrence after liver transplantation OLT is based on interferon (IFN) and ribavirin (RBV) in monotherapy or combination. The rate of sustained virological response (SVR) varies between 10% and 45%. We have retrospectively analyzed factors that could predict SVR after antiviral therapy. We analyzed 42 patients who completed a cycle of therapy with natural or pegylated IFN plus RBV. There were 15 (35.7%) patients who obtained an SVR. The following factors were significantly associated with a lack of SVR: donor age >or=50 years (P = .046); donor body mass index (BMI) > 27 (P = .016); genotype 1 versus 2 to 3 (P = 0.010), aspartate transferase (AST) before therapy >or= 140 U/L (P = .046), alanine transferase before therapy >or= 280 U/L (P = .055), use of natural IFN versus pegylated IFN (P = .016). The only factors remaining after multivariate analysis were: donor BMI, AST before therapy and genotype. Our data confirmed that genotype 1 was associated with poorer outcomes; other additional parameters can influence the response to antiviral therapy.
Chirurgia Trapianti di Fegato e Multiviscerale, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
M
M
Marino
R M
RM
Iemmolo
R
R
Montalti
M
M
Bertolotti
F
F
Di Benedetto
N
N
De Ruvo
N
N
Cautero
G
G
Guerrini
M G
MG
De Blasiis
G E
GE
Gerunda
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D005838:Genotype; D006526:Hepatitis C / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D017211:Treatment Failure
D000998:Antiviral Agents; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase