Premium
Predictors of sustained virological response after antiviral treatment for hepatitis C recurrence following liver transplantation
Author(s) -
Cescon Matteo,
Grazi Gian Luca,
Cucchetti Alessandro,
Vetrone Gaetano,
Ravaioli Matteo,
Ercolani Giorgio,
Morelli Maria Cristina,
Piscaglia Fabio,
Tamè Mariarosa,
Pinna Antonio Daniele
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21760
Subject(s) - medicine , odds ratio , liver transplantation , gastroenterology , immunosuppression , confidence interval , tacrolimus , ribavirin , discontinuation , azathioprine , hepatitis c , transplantation , hepatitis c virus , immunology , virus , disease
Factors associated with sustained virological response (SVR) in patients treated for hepatitis C virus (HCV) recurrence after liver transplantation (LT) are unclear. Ninety‐nine HCV‐positive/hepatitis B surface antigen–negative patients received antiviral treatment (AVT) with interferon/peginterferon plus ribavirin for HCV recurrence after LT. Cyclosporine (CyA) or tacrolimus (TAC) was used as the main immunosuppressor in 37 (37%) and 62 (63%) patients, respectively. Twenty‐five patients (25%) achieved an SVR. Twenty‐seven donor‐related, recipient‐related, HCV‐related, and immunosuppression‐related variables were investigated for their association with SVR. In logistic regression analysis, donor age < 60 years (odds ratio = 4.45, 95% confidence interval = 1.39‐14.19, P = 0.01), viral genotype other than 1 (odds ratio = 4.97, 95% confidence interval = 1.59‐15.48, P = 0.006), and the use of CyA during treatment (odds ratio = 6.85, 95% confidence interval = 2.15‐21.73, P = 0.001) were predictors of SVR. Patients treated with CyA (SVR rate: 43%) and those treated with TAC (SVR rate: 14%) were comparable for all variables, except for a shorter ischemia time and shorter timing of AVT initiation in the TAC group ( P = 0.02 and P = 0.005, respectively) and a greater use of anti‐CD25 antibodies, azathioprine, and mycophenolate mofetil in the CyA group ( P = 0.03, P < 0.001, and P = 0.001, respectively). The rate of AVT discontinuation due to side effects was similar between groups (16% versus 8%, P = 0.3). In conclusion, the type of immunosuppression during AVT may predict SVR in patients treated for HCV recurrence after LT. Liver Transpl 15:782–789, 2009. © 2009 AASLD.