title: Treatment of hepatitis C-virus-reinfection after liver transplant with silibinin in nonresponders to pegylated interferon-based therapy.
abstract: OBJECTIVE
  Hepatitis C-virus-persistence after orthotopic liver transplant leads to reduced patient and graft survival compared to other indications. Current interferon-based antiviral therapy of hepatitis C-virus-infection posttransplant provides a sustained response rate of 30% to 40%. This study, performed in an hepatitis C-virus-reinfected liver transplant population, examines the antiviral effect of intravenously administered silibinin, recently reported to exhibit strong antiviral properties in the natural setting of hepatitis C-virus-related liver disease.
  
  
  METHODS
  Four patients after orthotopic liver transplant with hepatitis C-virus-recurrence, previously having not responded to peg-interferon-ribavirin therapy, were treated with intravenous silibinin and additionally, after the 10th day, with standard interferon-based therapy. Aminotransferases and hepatitis C-virus-RNA were measured during treatment.
  
  
  RESULTS
  All patients demonstrated normalization of liver enzymes and significant decline of hepatitis C-virus-RNA measured at day 10 (mean 2.8 logarithmic levels: 1.7, 2.3, 2.9, and 4.3) during silibinin monotherapy. One patient cleared hepatitis C-virus-RNA under silibinin monotherapy and another patient eliminated hepatitis C virus under subsequent interferon-based therapy. No adverse effects were observed during silibinin application.
  
  
  CONCLUSIONS
  Intravenous silibinin is an effective therapeutic approach for treating hepatitis C-virus-reinfection after liver transplant and should be evaluated further.
authors: Department of General, Visceral and Transplant Surgery, Charite Campus Virchow, Berlin, Germany. dennis.eurich@charite.de
authors: Dennis
authors: D
authors: Eurich
authors: Marcus
authors: M
authors: Bahra
authors: Thomas
authors: T
authors: Berg
authors: Sabine
authors: S
authors: Boas-Knoop
authors: Michael
authors: M
authors: Biermer
authors: Ruth
authors: R
authors: Neuhaus
authors: Peter
authors: P
authors: Neuhaus
authors: Ulf
authors: U
authors: Neumann