Clinical and histological efficacy of pegylated interferon and ribavirin therapy of recurrent hepatitis C after liver transplantation

✍ Scribed by Inmaculada Fernández; Juan Carlos Meneu; Francisco Colina; Ignacio García; Raquel Muñoz; Gregorio Castellano; Antonio Fuertes; Manuel Abradelo; Carlos Lumbreras; Enrique Moreno; José Antonio Solís-Herruzo

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 143 KB
• Volume: 12
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20883

✦ Synopsis

Treatment of recurrent hepatitis C in liver transplant is controversial. The aim of our study was to evaluate the clinical and histological efficacy of pegylated interferon alpha 2b (PEG-IFN) and ribavirin therapy of recurrent hepatitis C after liver transplantation (LT). We prospectively included 47 liver transplant patients with: 1) a positive test for hepatitis C virus (HCV)-ribonucleic acid (RNA) in serum; 2) alanine aminotransferase (ALT) Ͼ45 IU/L; and 3) a liver biopsy showing chronic hepatitis without rejection in the previous 2 months. Patients received PEG-IFN (1.5 g/kg/week) and ribavirin (800-1,000 mg/day) for 12 months. Follow-up was based on biochemical (ALT), virological (RNA-HCV), and histological (liver biopsy) examinations. Follow-up lasted a minimum of 6 months after the end of antiviral therapy. Sustained virological response (SVR) was achieved in 23% of the patients. A total of 33 (70%) patients had normalized ALT levels at the end of therapy. Inflammatory portal and lobular score declined significantly in patients with SVR (P Ͻ 0.05) but not in nonresponder patients. Fibrosis did not change significantly in either group. SVR was significantly associated with low ␥-glutamyltransferase GGT (P ϭ 0.04) and HCV-RNA levels (P ϭ 0.03), a virological response at 12 weeks (P ϭ 0.002) and patient's compliance (P ϭ 0.04). Ten (21%) patients were withdrawn prematurely due to adverse effects. In conclusion, Therapy with PEG-IFN and ribavirin achieved SVR and a significant histological improvement in 23% of liver transplant recipients with chronic hepatitis C. Toxicity is an important drawback of this therapy.