title: Slower Fibrosis Progression Among Liver Transplant Recipients With Sustained Virological Response After Hepatitis C Treatment.
abstract: BACKGROUND
  The natural course of hepatic fibrosis in HCV allograft recipients with sustained virological response (SVR) after anti-HCV therapy remains debatable. The aim of this study was to examine the progression of fibrosis in a cohort of patients who achieved SVR compared with those without treatment.
  
  
  METHODS
  The 167 patients who met the inclusion and exclusion criteria were chosen from a transplant database. All patients were required to have histological evidence of recurrent HCV infection post-liver transplantation and a follow-up biopsy. The 140 of these patients had received anti-viral therapy. Twenty-seven patients were identified as controls and were matched with the treatment group in all respects. The patients were categorized into four groups based on treatment response: 1) no treatment (control) (n = 27); 2) non-responders (n = 81); 3) relapsers (n = 32); and 4) SVR (n = 27). The endpoint was the stage of fibrosis on the follow-up liver biopsy.
  
  
  RESULTS
  The treated and untreated groups were similar in clinical characteristics at the time of transplantation and prior to the initiation of treatment. The 72% of the cohort showed a fibrosis progression of ≥ 1 stage; this change did not significantly differ between the patient groups. Nonetheless, the fibrosis progression rate was the highest in the untreated group and lowest in the patients who achieved SVR. A coefficient of determination was used. Improvements in fibrosis scores were found with greater treatment duration. These improvements were most evident with the achievement of SVR.
  
  
  CONCLUSIONS
  In conclusion, SVR after anti-viral therapy for recurrent hepatitis C infection post-transplantation was associated with slower fibrosis progression and significantly improved graft survival.
authors: Liver Institute, Department of Internal Medicine, Divisions of Gastroenterology, Hepatology and Transplantation, University of Arizona, AZ, USA.
authors: Shahid
authors: S
authors: Habib
authors: Department of Medicine, University of Arizona, AZ, USA.
authors: Edward
authors: E
authors: Meister
authors: Liver Institute, Department of Internal Medicine, Divisions of Gastroenterology, Hepatology and Transplantation, University of Arizona, AZ, USA.
authors: Sana
authors: S
authors: Habib
authors: Liver Institute, Department of Internal Medicine, Divisions of Gastroenterology, Hepatology and Transplantation, University of Arizona, AZ, USA.
authors: Traci
authors: T
authors: Murakami
authors: Liver Institute, Department of Internal Medicine, Divisions of Gastroenterology, Hepatology and Transplantation, University of Arizona, AZ, USA.
authors: Courtney
authors: C
authors: Walker
authors: Division of Transplantation Surgery, Department of Surgery, Baylor College of Medicine, TX, USA.
authors: Abbas
authors: A
authors: Rana
authors: Division of Transplantation Surgery and Thomas E. Starzl Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: Obaid S
authors: OS
authors: Shaikh
keywords: Fibrosis progression; Liver allograft; Modified Ishak-Knodell activity index; Patient and graft survival; Retrospective study