title: Treatment of hepatitis C recurrence is less successful in female than in male liver transplant recipients.
abstract: It has been recently suggested that the risk of graft loss after liver transplantation (LT) may increase in female HCV patients. The aim of the study was to examine gender differences in HCV therapy tolerance and outcome in LT patients treated for HCV recurrence. A retrospective study was conducted on liver recipients with HCV recurrence, who were given antiviral therapy from 2001 to 2009 in 12 transplant centers in Italy. Sustained virological response (SVR), adherence-to-therapy, and side effects were evaluated. A multivariate logistic regression model was used after adjusting for possible confounders. The data regarding 342 treated patients were analyzed. SVR was reported in 38.8% of patients. At baseline, male and female did not differ in HCV viral load, histology, or rate of diabetes. SVR was lower in females than in males (29.5% vs. 42.1%; P=0.03). Adherence-to-therapy was also lower in females than in males 43.4% vs. 23.8%; P=0.001); anemia was the main reason for lower adherence. In a multivariate analysis in patients Genotype1, female gender (P<0.04), early virological response (P<0.0001), and adherence to therapy (P<0.0001) were independent predictors for SVR. In conclusion, female gender represents an independent negative prognostic factor for the outcome of HCV antiviral therapy after LT.
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Giannelli
authors.forename: Michela
authors.initials: M
authors.lastname: Giusto
authors.forename: Alessio
authors.initials: A
authors.lastname: Farcomeni
authors.forename: Francesca R
authors.initials: FR
authors.lastname: Ponziani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Raffaella
authors.initials: R
authors.lastname: Viganò
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Iemmolo
authors.forename: Maria F
authors.initials: MF
authors.lastname: Donato
authors.forename: Maria
authors.initials: M
authors.lastname: Rendina
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Toniutto
authors.forename: Luisa
authors.initials: L
authors.lastname: Pasulo
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Morelli
authors.forename: Eleonora
authors.initials: E
authors.lastname: De Martin
authors.forename: Lucia
authors.initials: L
authors.lastname: Miglioresi
authors.forename: Daniele
authors.initials: D
authors.lastname: Di Paolo
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000821:virology*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D012737:Sex Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D011092:Polyethylene Glycols; D012254:Ribavirin