Pegylated Interferon and Ribavirin for the Recurrence of Chronic Hepatitis C Genotype 1 in Transplant Patients

• Published in: Transplantation proceedings Vol. 37; no. 9; pp. 3963 - 3964
• Main Authors: Oton, E., Barcena, R., Garcia-Garzon, S., Moreno-Zamora, A., Moreno, A., Garcia-Gonzalez, M., Blesa, C., Foruny, J.R., Ruiz, P.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2005; Elsevier Science
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Biopsy; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatitis B - drug therapy; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - pathology; Humans; Interferon-alpha - therapeutic use; Lamivudine - therapeutic use; Liver Transplantation; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Polyethylene Glycols - therapeutic use; Recombinant Proteins; Recurrence; Ribavirin - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Treatment Outcome; Human; Graft(material); Recurrence; Relapse; Typing; Cytokine; Hepatic disease; Genotype; Patient; Transplantation; Homotransplantation; Ribavirin; Infection; Medicine; Treatment; Surgery; Viral disease; Digestive diseases; Antiviral; Graft; Interferon; Pegylated form; Viral hepatitis C
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.10.060

The efficacy of pegylated interferon (p-IFN) and ribavirin (RB) in transplant patients is not well known. Chronic hepatitis C evolves in a more aggressive form after transplantation, causing a worse survival. Twenty-one naïve patients with recurrent chronic hepatitis C demonstrated by biopsy were treated for 48 weeks with p-IFN alpha2b (1.5 μg/kg/wk) and RB (>10.6 mg/kg/d). Quantification of RNA was performed (Amplicor Cobas 2.0 Roche) at baseline, 4, 12, 24, 48, and 72 weeks. A qualitative technique was used when quantitative levels were undetectable. At more than 1 year since liver transplantation we did not detect coinfection with human immunodeficiency virus or use steroid treatment. Among the cohort there were 16 men (76.2%). The mean overall age was 52 ± 12 years. Time from liver transplant to treatment was 1637 ± 1030 days. They were all infected with genotype 1. Eight patients received cyclosporine and the others tacrolimus. One patient was coinfected with hepatitis B virus and was receiving lamivudine. The mean initial histological activity index was 6.9 ± 1.5 and fibrosis, 2.52 ± 1.8 (Ishak). Two patients needed spleen embolization before the treatment. Two patients had to stop the treatment: one due to clinical intolerance, and the other one due to a cholangitis. In 14%, p-IFN doses were adjusted. In 32% RB was adjusted. Five (23.8%) did not respond at 24 weeks. Fourteen (66.7%) showed end-treatment responses but four relapsed at 72 weeks. A sustained viral response was achieved in 9 (42.8%). One patient died due to arterial thrombosis just after completing the treatment.