Effectiveness of Pegylated Interferon and Ribavirin in Patients With Liver HCV Cirrhosis

• Published in: Transplantation proceedings Vol. 37; no. 3; pp. 1482 - 1483
• Main Authors: Moreno Planas, J.M., Rubio González, E., Boullosa Graña, E., Fernández Ruiz, M., Jiménez Garrido, M., Lucena de la Poza, J.L., Martı́nez Arrieta, F., Molina Miliani, C., Sánchez Turrión, V., Cuervas-Mons Martı́nez, V.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2005; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; Drug Therapy, Combination; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis C - drug therapy; Hepatitis C - surgery; Humans; Interferon-alpha - therapeutic use; Liver Cirrhosis - etiology; Liver Cirrhosis - virology; Liver Transplantation; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Polyethylene Glycols; Recombinant Proteins; Ribavirin - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Treatment Outcome; Human; Digestive system; Cytokine; Hepatic disease; Patient; Transplantation; Ribavirin; Virus; Medicine; Cirrhosis; Treatment; Efficiency; Surgery; Digestive diseases; Antiviral; Graft; Interferon; Flaviviridae; Pegylated form; Hepatitis C virus; Hepacivirus
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.02.041

Clearance of HCV before transplantation could avoid recurrence of hepatitis C in the liver allograft, thereby improving graft and patient survival. We report our experience with combined therapy for patients with HCV cirrhosis, including 12 patients with biopsy-proven liver cirrhosis (n = 7) or previous cirrhotic complications (n = 5). The Child–Pugh score was A in eight patients and B in four. Two patients had hepatocellular carcinoma. Genotype distribution was 1a (n = 2), 1b (n = 8) or 3 (n = 1). Patients received peginterferon α2b (1.5 μg/kg once weekly) and ribavirin (10.6 g/kg per day) for 48 weeks (genotype 1) or 24 weeks (genotype 3). Twenty-one months after beginning therapy all the patients remained alive; three have undergone liver transplantation. In one patient treatment was discontinued after 2 months due to cachexia. End-of-treatment virologic response was achieved in five patients (41.7%) and sustained virologic response in three patients (25%). Patients who cleared the virus had negative PCR 4 weeks after beginning therapy. All patients had adverse events. The most common clinical events were asthenia, weight loss, fever, and anorexia. Infectious complications resolved in three patients (25%). Hematologic events were common. Seven of 11 patients (63.6%) who completed therapy required dose reduction. We conclude that therapy with peginterferon and ribavirin in patients with HCV cirrhosis has a similar effectiveness to previous treatments. A virologic response 1 month after the beginning of therapy could be a main predictor of a sustained response.