title: Treatment of recurrent genotype 4 hepatitis C after liver transplantation: early virological response is predictive of sustained virological response. An AISF RECOLT-C group study.
abstract: BACKGROUND
  Hepatitis C virus genotype 4 is predominant in the Middle East and Northern Africa, even if it has recently spread to Southern Europe. Data about the treatment of post-liver transplantation (LT) genotype 4 hepatitis C recurrence are scarce. We report a retrospective analysis of post-LT genotype 4 hepatitis C treatment in 9 Italian transplant centres, focusing on the overall survival rates and treatment outcome.
  
  
  RESULTS
  Among 452 recipients, we identified 17 HCV genotype 4 patients (16 males, 1 female) transplanted between 1998 and 2007. All patients received combined antiviral treatment with conventional doses of interferon (recombinant or pegylated) and ribavirin after histological diagnosis of hepatitis C recurrence. The observed overall survival after LT was 100% at 1 year and 83.3% at 5 years. More than 1/3 (35.3%) of patients achieved a sustained virological response (SVR) and 40% (data available in 15 subjects) an early virological response (EVR), which was significantly associated with the achievement of SVR (overall accuracy: 85.7%; predictive values of EVR absence/presence 80/88.8%; chi-square p < 0.05).
  
  
  CONCLUSIONS
  In conclusion, in post-LT genotype 4 hepatitis C treatment, SVR rates are similar to genotype 1. Patients who don't show an EVR are not likely to achieve a SVR.
authors.affiliation: AISF RECOLT-C group: Catholic University of Rome, Italy. francesca.ponziani@yahoo.it
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Ponziani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Milani
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Raffaella
authors.initials: R
authors.lastname: Zaccaria
authors.forename: Raffaella
authors.initials: R
authors.lastname: Viganò
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Donato
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Morelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Miglioresi
authors.forename: Luisa
authors.initials: L
authors.lastname: Pasulo
authors.forename: Maria
authors.initials: M
authors.lastname: Rendina
authors.forename: Daniele Di
authors.initials: DD
authors.lastname: Paolo
authors.forename: Maria
authors.initials: M
authors.lastname: Marino
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Toniutto
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007558:Italy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a