title: Hepatitis C virus recurrence after liver transplantation: a 10-year evaluation.
abstract: OBJECTIVE
  To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence.
  
  
  METHODS
  Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ(2), Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic regression.
  
  
  RESULTS
  The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status (mild hepatitis C recurrence, "too sick to be treated" and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different (59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the "non-responders" (84.7% vs 39.8%, P < 0.0001) and too sick to be treated (84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence (84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival.
  
  
  CONCLUSIONS
  Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence.
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Stefano
authors: S
authors: Gitto
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Luca Saverio
authors: LS
authors: Belli
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Ranka
authors: R
authors: Vukotic
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Stefania
authors: S
authors: Lorenzini
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Aldo
authors: A
authors: Airoldi
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Arrigo Francesco Giuseppe
authors: AF
authors: Cicero
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Marcello
authors: M
authors: Vangeli
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Lucia
authors: L
authors: Brodosi
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Arianna Martello
authors: AM
authors: Panno
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Roberto
authors: R
authors: Di Donato
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Matteo
authors: M
authors: Cescon
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Gian Luca
authors: GL
authors: Grazi
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Luciano
authors: L
authors: De Carlis
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Antonio Daniele
authors: AD
authors: Pinna
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Mauro
authors: M
authors: Bernardi
authors: Stefano Gitto, Ranka Vukotic, Stefania Lorenzini, Arrigo Francesco Giuseppe Cicero, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone, Department of Medical and Surgical Sciences, University of Bologna and Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola Malpighi, 40138 Bologna, Italy.
authors: Pietro
authors: P
authors: Andreone
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000254:growth & development; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents
keywords: Antiviral treatment; Hepatitis C; Hepatitis C virus recurrence; Liver transplantation; Ten-year survival