Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C.

Abstract

BACKGROUND:

The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival.

AIM:

To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis C recurrence.

METHODS:

436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis C recurrence were retrospectively evaluated.

RESULTS:

The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008).

CONCLUSIONS:

Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.

• Authors: Francesca Romana Ponziani, Raffaella Viganò, Rosa Maria Iemmolo, Maria Francesca Donato, Maria Rendina, Pierluigi Toniutto, Luisa Pasulo, Maria Cristina Morelli, Patrizia Burra, Lucia Miglioresi, Manuela Merli, Daniele Di Paolo, Stefano Fagiuoli, Antonio Gasbarrini, Maurizio Pompili, AISF RECOLT-C Group, L Belli, G E Gerunda, M Marino, R Montalti, F Di Benedetto, N De Ruvo, C Rigamonti, M Colombo, G Rossi, A Di Leo, L Lupo, V Memeo, R Bringiotti, M Zappimbulso, D Bitetto, V Vero, M Colpani, E Fornasiere, A D Pinna, M C Morelli, V Bertuzzo, E De Martin, M Senzolo, G M Ettorre, U Visco-Comandini, G Antonucci, M Angelico, G Tisone, V Giannelli, M Giusto
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 46 Issue 5 Pg. 440-5 (May 2014) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 24635906 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antiviral Agents
• interferon-lambda, human
• Interferon-alpha
• Interleukins
• RNA, Viral
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• Interferons
• peginterferon alfa-2a

Topics

• Antiviral Agents (therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Genotype
• Graft Survival
• Hepacivirus (genetics)
• Hepatitis C, Chronic (blood, drug therapy, mortality)
• Humans
• Interferon-alpha (therapeutic use)
• Interferons
• Interleukins (genetics)
• Liver Transplantation (mortality)
• Maintenance Chemotherapy (methods)
• Male
• Middle Aged
• Polyethylene Glycols (therapeutic use)
• RNA, Viral (blood)
• Recombinant Proteins (therapeutic use)
• Recurrence
• Retrospective Studies
• Ribavirin (therapeutic use)
• Survival Rate
• Time Factors