title: Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy.
abstract: This prospective study was initiated in 1993 with the aim to study late effects and responses to antiviral therapy in a cohort of hepatitis C virus (HCV)-infected patients. A total of 195 patients were included from 12 centers. In all, 134 patients had undergone allogeneic and 61 autologous hematopoietic SCT (HSCT). The median follow-up from HSCT is currently 16.8 years and the maximum 27.2 years. Overall 33 of 195 patients have died of which 6 died from liver complications. The survival probability was 81.6% and the cumulative incidence for death in liver complications was 6.1% at 20 years after HSCT. The cumulative incidence of severe liver complications (death from liver failure, cirrhosis and liver transplantation) was 11.7% at 20 years after HSCT. In all, 85 patients have been treated with IFN; 42 in combination with ribavirin. The sustained response rate was 40%. The rates of severe side effects were comparable to other patient populations and no patient developed significant exacerbations of GVHD. Patients receiving antiviral therapy had a trend toward a decreased risk of severe liver complications (odds ratio=0.33; P=0.058). HCV infection is associated with morbidity and mortality in long-term survivors after HSCT. Antiviral therapy can be given safely and might reduce the risk for severe complications.
authors.affiliation: Department of Hematology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. Per.Ljungman@ki.se
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: A
authors.initials: A
authors.lastname: Locasciulli
authors.forename: V G
authors.initials: VG
authors.lastname: de Soria
authors.forename: A N
authors.initials: AN
authors.lastname: Békássy
authors.forename: L
authors.initials: L
authors.lastname: Brinch
authors.forename: I
authors.initials: I
authors.lastname: Espigado
authors.forename: A
authors.initials: A
authors.lastname: Ferrant
authors.forename: I M
authors.initials: IM
authors.lastname: Franklin
authors.forename: J
authors.initials: J
authors.lastname: O'Riordan
authors.forename: M
authors.initials: M
authors.lastname: Rovira
authors.forename: P
authors.initials: P
authors.lastname: Shaw
authors.forename: H
authors.initials: H
authors.lastname: Einsele
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000601:surgery / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006526:Hepatitis C / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents