title: Treatment of genotype-1 hepatitis C recurrence after liver transplant improves survival in both sustained responders and relapsers.
abstract: The aim of this study was to evaluate the factors affecting the response to treatment and how it could affect survival in a large series of genotype-1 HCV-transplanted patients. Three-hundred and twenty six genotype-1 HCV patients were enrolled. One hundred and ninety-six patients (60.1%) were nonresponders and 130 (39.9%) showed negative HCV-RNA at the end of treatment. Eighty-four of them (25.8%) achieved sustained virological response, while 46 (14.1%) showed viral relapse. Five-year cumulative survival was significantly worse in nonresponders (76.4%) compared with sustained viral response (93.2) or relapsers (94.9%). Sustained responders and relapsers were therefore considered as a single 'response group' in further analysis. Pretreatment variables significantly associated with virological response at multivariate regression analysis were the absence of ineffective pretransplant antiviral therapy, the recurrence of HCV-hepatitis more than 1 year after transplant, an histological grading ≥4 at pretreatment liver biopsy, a pretreatment HCV-RNA level <1.2 × 10(6 ) IU/ml, and the absence of diabetes. As expected, also on-treatment variables (rapid and early virological response) were significantly associated to the response to antiviral treatment. In conclusion, this study shows that postliver transplant antiviral treatment results in beneficial effect on survival not only in sustained responders but also in relapsers.
authors.affiliation: Agostino Gemelli Hospital, 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: Rosa Maria
authors.initials: RM
authors.lastname: Iemmolo
authors.forename: Maria Francesca
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: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Lucia
authors.initials: L
authors.lastname: Miglioresi
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.forename: Daniele Di
authors.initials: DD
authors.lastname: Paolo
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006084:Graft Rejection; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D007558:Italy; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000008:administration & dosage; D012008:Recurrence; D012044:Regression Analysis; D019233:Retreatment; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a