Combined treatment with pegylated interferon (alpha-2b) and ribavirin in the acute phase of hepatitis C virus recurrence after liver transplantation.

Abstract

BACKGROUND/AIMS:

The efficacy and safety of treatment with pegylated interferon alpha-2b (Peg-Intron, 1.5 microg/kg) and ribavirin (400-800 mg) in the acute phase of recurrent HCV after LT is presented.

METHODS:

Twenty-four patients (17 men) transplanted for HCV-associated cirrhosis (genotype 1b) were treated for at least 6 months and compared with 24 consecutive transplant patients (16 men) without antiviral therapy (controls).

RESULTS:

At completion of treatment, 14/24 treated patients (58%) achieved HCV-RNA negativity, compared to none of controls (P<0.0001). Sustained virological response (SVR) occurred in 8/23 treated patients (34.7%) who reached week 24 after treatment and none of controls (P<0.005). At 12 weeks after treatment, 15/24 patients (62.5%) had an early virological response (EVR) (seven tested HCV-RNA negative). SVR was associated with absence of corticosteroid bolus administration (P=0.01), presence of EVR (P=0.002) and absence of cytomegalovirus infection (P=0.001). Haematological adverse effects included anaemia, 17/24 cases (71%) and leukopenia, 23/24 cases (96%). One patient presented mild acute rejection that resolved by adjusting immunosuppressive dose.

CONCLUSIONS:

Treatment with pegylated interferon alpha-2b plus ribavirin in the acute phase of HCV reinfection yielded an EVR of 62.5% and a SVR of 34.7%. The combination was safe, with a low rate of therapy withdrawal.

• Authors: Lluís Castells, Víctor Vargas, Helena Allende, Itxarone Bilbao, José Luis Lázaro, Carlos Margarit, Rafael Esteban, Jaime Guardia
• Journal: Journal of hepatology (J Hepatol) Vol. 43 Issue 1 Pg. 53-9 (Jul 2005) ISSN: 0168-8278 [Print] Netherlands
• PMID: 15876467 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• RNA, Viral
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• Alanine Transaminase
• peginterferon alfa-2b

Topics

• Aged
• Alanine Transaminase (blood)
• Antiviral Agents (adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hepacivirus (genetics)
• Hepatitis C (blood, complications, drug therapy, virology)
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects, therapeutic use)
• Liver Cirrhosis (surgery, virology)
• Liver Transplantation
• Male
• Middle Aged
• Polyethylene Glycols
• Postoperative Period
• RNA, Viral (blood)
• Recombinant Proteins
• Recurrence
• Ribavirin (adverse effects, therapeutic use)
• Time Factors