Effect of maintenance therapy with low-dose peginterferon for recurrent hepatitis C after living donor liver transplantation.

Abstract

Approximately 30% of patients who have recurrent hepatitis C after liver transplantation achieve sustained virological response (SVR) by taking a combination therapy of pegylated interferon and ribavirin. For the remaining non-SVR patients, an effective management treatment has not yet been established. In this study, efficacy of long-term peginterferon maintenance therapy for non-SVR patients was evaluated. Forty patients who had previously received the combination therapy for hepatitis C after living donor liver transplantation were classified into one of the following three groups: the SVR group (n = 11); the non-SVR-IFN group (n =17), which received low-dose peginterferon maintenance therapy for non-SVR patients; and the non-SVR-Withdrawal group (n = 12), which discontinued the interferon treatment. We then compared histological changes among these three groups after 2 or more years follow-up. Activity grade of liver histology improved or remained stable in patients in the SVR and non-SVR-IFN groups, but deteriorated in half of the patients in the non-SVR-Withdrawal group. Fibrosis improved or remained stable in 10 of 11 SVR patients and in 13 of 17 non-SVR-IFN patients, but deteriorated in all non-SVR-Withdrawal patients. Mean changes in fibrosis stage between pretreatment and final liver biopsy were -0.18, +0.06 and +2.2 in the SVR, non-SVR-IFN and non-SVR-Withdrawal groups, respectively. Fibrosis stage deteriorated to F3 or F4 significantly more rapidly in the non-SVR-Withdrawal group than in the other two groups. In conclusion, continuing long-term maintenance therapy with peginterferon prevented histological progression of hepatitis C in patients who had undergone living donor liver transplantation.

• Authors: Y Ueda, H Marusawa, T Kaido, Y Ogura, F Oike, A Mori, K Ogawa, A Yoshizawa, E Hatano, A Miyagawa-Hayashino, H Haga, H Egawa, Y Takada, S Uemoto, T Chiba
• Journal: Journal of viral hepatitis (J Viral Hepat) Vol. 19 Issue 1 Pg. 32-8 (Jan 2012) ISSN: 1365-2893 [Electronic] England
• PMID: 21129128 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 Blackwell Publishing Ltd.

Chemical References

• Antiviral Agents
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• peginterferon alfa-2a

Topics

• Adolescent
• Adult
• Aged
• Antiviral Agents (administration & dosage, therapeutic use)
• Disease Progression
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hepacivirus (drug effects)
• Hepatitis C, Chronic (drug therapy, pathology)
• Humans
• Interferon-alpha (therapeutic use)
• Liver (pathology)
• Liver Transplantation
• Living Donors
• Male
• Middle Aged
• Polyethylene Glycols (therapeutic use)
• Recombinant Proteins (therapeutic use)
• Recurrence
• Ribavirin (therapeutic use)
• Treatment Outcome
• Young Adult