Premium
Pegylated interferon‐alpha 2a /ribavirin treatment of recurrent hepatitis C after liver transplantation
Author(s) -
Dinges S.,
Morard I.,
Heim M.,
Dufour J.F.,
Müllhaupt B.,
Giostra E.,
Clavien P.A.,
Mentha G.,
Negro F.
Publication year - 2009
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2008.00359.x
Subject(s) - ribavirin , medicine , pegylated interferon , gastroenterology , liver transplantation , hepatitis c , hepatitis c virus , transplantation , immunology , virus
Hepatitis C virus (HCV) infection invariably recurs after liver transplantation (LT), leading to significant morbidity and mortality. Although the combination of pegylated interferon‐alpha (IFN‐α)/ribavirin is the preferred treatment for these patients, the optimal schedule remains undetermined. In an uncontrolled trial, 19 patients with HCV infection recurring after LT received pegylated IFN‐α 2a , 180 μg weekly, and ribavirin, 10 mg/kg body weight daily, for 48 weeks. The proportion of patients with undetectable HCV RNA in their serum after 12 weeks of treatment was 53%. Five patients (26%) dropped out of the study due to intolerance (in 2 cases), depression (in 1), or infectious complications (in 2). A sustained virological response (SVR), defined as undetectable serum HCV RNA 24 weeks after the end of treatment, was observed in 9/19 patients (47%). SVR was associated with an early virological response after 12 weeks of therapy ( P <0.001) and a treatment duration >80% ( P =0.02), but not with baseline HCV RNA level or a cumulative dose of pegylated IFN‐α 2a or ribavirin >80% of the scheduled dose. All 4 patients with genotype 2 or 3 reached SVR, as compared with 33% of patients with genotype 1 or 4 ( P =0.03). A 48‐week course of pegylated IFN‐α 2a /ribavirin therapy is effective in patients with recurrent HCV infection after LT.