title: Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C.
abstract: BACKGROUND
  The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival.
  
  
  OBJECTIVE
  To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis C recurrence.
  
  
  METHODS
  436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis C recurrence were retrospectively evaluated.
  
  
  RESULTS
  The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008).
  
  
  CONCLUSIONS
  Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.
authors.affiliation: Agostino Gemelli Hospital, Rome, Italy. Electronic address: francesca.ponziani@yahoo.it.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Ponziani
authors.affiliation: Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Viganò
authors.affiliation: University of Modena, Modena, Italy.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Iemmolo
authors.affiliation: IRCCS Foundation Ca' Granda Maggiore Hospital, Milan, Italy.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Donato
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Rendina
authors.affiliation: University of Udine, Udine, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Toniutto
authors.affiliation: Ospedali Riuniti, Bergamo, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Pasulo
authors.affiliation: Sant'Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Morelli
authors.affiliation: University of Padua, Padua, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.affiliation: San Camillo Spallanzani Hospital, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Miglioresi
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.affiliation: University of Torvergata, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Di Paolo
authors.affiliation: Ospedali Riuniti, Bergamo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.affiliation: Agostino Gemelli Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Agostino Gemelli Hospital, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: L
authors.initials: L
authors.lastname: Belli
authors.forename: G E
authors.initials: GE
authors.lastname: Gerunda
authors.forename: M
authors.initials: M
authors.lastname: Marino
authors.forename: R
authors.initials: R
authors.lastname: Montalti
authors.forename: F
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: N
authors.initials: N
authors.lastname: De Ruvo
authors.forename: C
authors.initials: C
authors.lastname: Rigamonti
authors.forename: M
authors.initials: M
authors.lastname: Colombo
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Di Leo
authors.forename: L
authors.initials: L
authors.lastname: Lupo
authors.forename: V
authors.initials: V
authors.lastname: Memeo
authors.forename: R
authors.initials: R
authors.lastname: Bringiotti
authors.forename: M
authors.initials: M
authors.lastname: Zappimbulso
authors.forename: D
authors.initials: D
authors.lastname: Bitetto
authors.forename: V
authors.initials: V
authors.lastname: Vero
authors.forename: M
authors.initials: M
authors.lastname: Colpani
authors.forename: E
authors.initials: E
authors.lastname: Fornasiere
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
authors.forename: M C
authors.initials: MC
authors.lastname: Morelli
authors.forename: V
authors.initials: V
authors.lastname: Bertuzzo
authors.forename: E
authors.initials: E
authors.lastname: De Martin
authors.forename: M
authors.initials: M
authors.lastname: Senzolo
authors.forename: G M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: U
authors.initials: U
authors.lastname: Visco-Comandini
authors.forename: G
authors.initials: G
authors.lastname: Antonucci
authors.forename: M
authors.initials: M
authors.lastname: Angelico
authors.forename: G
authors.initials: G
authors.lastname: Tisone
authors.forename: V
authors.initials: V
authors.lastname: Giannelli
authors.forename: M
authors.initials: M
authors.lastname: Giusto
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D016031:Liver Transplantation / Q000401:mortality; D060046:Maintenance Chemotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D015996:Survival Rate; D013997:Time Factors; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C100416:peginterferon alfa-2a
keywords: HCV antiviral treatment; Hepatitis C recurrence; Liver transplantation; Sustained viral response