PEGYLATED INTERFERON AND RIBAVIRIN FOR TREATMENT OF RECURRENT HEPATITIS C AFTER LIVER TRANSPLANTATION: a single-liver transplant center experience in Brazil.
BACKGROUND
Treatment of hepatitis C virus infection in post-transplantation patients is a challenge due to poor tolerance and low success rates.


OBJECTIVE
To determine the response rate to pegylated interferon and ribavirin in post-liver transplant patients with hepatitis C recurrence.


METHODS
Between 18 May 2002 and 18 December 2011, 601 patients underwent liver transplantation at our service (Hospital Universitário Walter Cantídio, University of Ceará), 176 (29.2%) of whom were hepatitis C virus positive. Forty received antiviral therapy and were included in this cohort study. Twenty-eight (70%) completed the treatment protocol, which consisted of pegylated interferon and ribavirin for 48 weeks.


RESULTS
The sustained virological response rate was 55% according to intention-to-treat analysis. Recipient age and exposure to antiviral drugs prior to liver transplantation were associated with sustained virological response in the multivariate analysis. Patients were followed for 57 months on the average. Survival at 1 and 5 years was 100% in responders, versus 100% and 78%, respectively, in non-responders.


CONCLUSIONS
Sustained virological response rates were satisfactory in our series of liver transplantation patients, and decreased with increasing recipient age. Non-exposure to antiviral drugs prior to liver transplantation was positively associated with sustained virological response. The overall survival of responders and non-responders was similar.
Departamento de Cirurgia de Fortaleza, Universidade Federal do Ceará, Fortaleza, CE, BR.
José Huygens Parente
JH
Garcia
Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Antônio Haroldo de
AH
Araújo Filho
Departamento de Medicina Interna, Universidade Federal do Ceará, Fortaleza, CE, BR.
Lucia Libanez Bessa Campelo
LL
Braga
Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Cyntia Ferreira Gomes
CF
Viana
Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Tarciso Daniel Santos
TD
Rocha
Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Karla Brandão
KB
Pereira
D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001938:Brazil; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D012307:Risk Factors; D055815:Young Adult
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin