title: Prolongation of interferon therapy for recurrent hepatitis C after living donor liver transplantation: analysis of predictive factors of sustained virological response, including amino acid sequence of the core and NS5A regions of hepatitis C virus.
abstract: OBJECTIVE
  The aim of the present retrospective study was to evaluate the therapeutic efficacy and predictive factors of prolongation of treatment with peginterferon (PEGIFN) combined with ribavirin (RBV) for recurrent hepatitis C after living donor liver transplantation (LDLT).
  
  
  METHODS
  Fifty-three patients underwent LDLT due to HCV-related end-stage liver disease. Sixteen patients were removed from the study as a result of early death (n=14), no recurrence of HCV (n=1) and refusal of antiviral therapy (n=1). Therapy is ongoing in another 10 patients. The remaining 27 patients were available to establish the efficacy of IFN therapy. HCV genotype was 1b in 24 patients. All patients with genotype 1b were treated with IFN therapy for at least 48 weeks after HCV RNA levels had become undetectable. Amino acid substitutions in the HCV core region and NS5A region were analyzed by direct sequencing before LDLT.
  
  
  RESULTS
  The rate of sustained virological response (SVR) was 37.0% (10/27). SVR rate in patients with genotype 1 was 29.2% (7/24) and 100% (3/3) in patients with genotype 2. Most patients with genotype 1b whose HCV RNA reached undetectable levels achieved SVR (87.5%; 7/8). However, mutation of the HCV core region and number of ISDR mutations were not associated with SVR rate in LDLT in our study.
  
  
  CONCLUSIONS
  Prolonged IFN therapy for more than 48 weeks after HCV RNA reached undetectable levels might prevent virological relapse of HCV.
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hiraga
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Fukiko
authors.initials: F
authors.lastname: Mitsui
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kimura
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Katamura
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Koji
authors.initials: K
authors.lastname: Waki
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000595:Amino Acid Sequence / Q000187:drug effects; D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000187:drug effects*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D011092:Polyethylene Glycols / Q000494:pharmacology / Q000627:therapeutic use; D011994:Recombinant Proteins; D012008:Recurrence; D012189:Retrospective Studies; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome; D017361:Viral Nonstructural Proteins; D012324:RNA-Dependent RNA Polymerase
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin; D017361:Viral Nonstructural Proteins; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase; C417083:peginterferon alfa-2b