Antiviral re-treatment of IFN-ribavirin non-responders for recurrent post-transplantation hepatitis C.

Abstract

BACKGROUND:

The aim of the study was to compare the efficacy and tolerability of pegylated interferon (PEG-IFN) plus ribavirin (RIB) and PEG-IFN monotherapy after unsuccessful initial therapy with interferon-α2b (IFN) plus RIB after recurrent post-transplantation hepatitis C.

METHODS:

Twenty-four patients with either no response (n = 10) or relapse (n = 14) after treatment with IFN plus RIB were prospectively randomized in the two treatment arms: 1) PEG-IFN monotherapy at a dosage of 0.8 μg/kg per week (n = 12) and 2) PEG-IFN (0.8 μg/kg per week) plus RIB (800-1200 mg/d) (n = 12).

RESULTS:

Twenty-one patients (86%) were treated for at least six months. Three patients are still being treated. At the end of therapy, 18 patients (75%) were HCV RNA negative. Five (45%) patients in PEG-IFN and five (50%) in PEG-IFN plus RIB arms had sustained virological response. Two patients (10%) died from recurrent hepatocellular carcinoma. The histologic activity indices significantly improved in both treatment arms. In the PEG-IFN arm, one patient experienced an acute rejection and discontinued therapy.

CONCLUSIONS:

Both treatment arms showed to be effective, well tolerated and lead to an improvement in histologic outcome. Because of lower rates in side effects and equal outcome, PEG-IFN monotherapy is an adequate option for antiviral re-treatment.

• Authors: Süleyman Yedibela, Resit Demir, Nathaniel Melling, Ünal Aydin, Detlef Schuppan, Volker Müller, Werner Hohenberger, Frank Schönleben
• Journal: Clinical transplantation (Clin Transplant) 2011 Jan-Feb Vol. 25 Issue 1 Pg. 131-5 ISSN: 1399-0012 [Electronic] Denmark
• PMID: 20438578 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2010 John Wiley & Sons A/S.

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• RNA, Viral
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin

Topics

• Adult
• Antiviral Agents (therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hepacivirus (genetics, pathogenicity)
• Hepatitis C (therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Liver Transplantation
• Male
• Middle Aged
• Polyethylene Glycols (therapeutic use)
• Prospective Studies
• RNA, Viral (genetics)
• Recombinant Proteins
• Retreatment
• Ribavirin (therapeutic use)
• Secondary Prevention
• Survival Rate
• Treatment Outcome
• Viral Load (drug effects)