Antiviral Treatment of Patients with Recurrent Hepatitis C After Liver Transplantation with Pegylated Interferon

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http://www.springerlink.com/content/u64t327p658hn387/

Journal Digestive Diseases and Sciences

Publisher Springer Netherlands

ISSN 0163-2116 (Print) 1573-2568 (Online)

Category Original Article

DOI 10.1007/s10620-009-0982-2

Subject Collection Medicine

SpringerLink Date Friday, October 02, 2009

Original Article

Antiviral Treatment of Patients with Recurrent Hepatitis C After Liver

Transplantation with Pegylated Interferon

Sven C. Schmidt1 , Marcus Bahra1, Bayraktar1, Berg2, Maximilian

Schmeding1, Johann Pratschke1, Neuhaus1 and Ulf Neumann1

(1) Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Charité

Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1,

13353 Berlin, Germany

(2) Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie,

Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger

Platz 1, 13353 Berlin, Germany

Received: 21 February 2009 Accepted: 9 September 2009 Published online: 2

October 2009

Abstract

Background The recurrence of hepatitis C virus (HCV) after liver

transplantation (OLT) leads to recurrent cirrhosis in up to 40% of patients.

Aims To identify patients who profit the most from antiviral therapy and to

delineate whether early treatment after OLT is effective to reach sustained

virological response (SVR), we analyzed factors associated to SVR during

pegylated interferon/ribavirin (PegIFN/RBV) therapy.

Methods A retrospective analysis of efficiency and viral decline kinetics in 83

HCV-infected liver transplant recipients who received therapy with PegIFN/RBV

was carried out.

Results Forty-one of 83 (49.4%) patients became HCV RNA-negative. SVR was

achieved in 26/83 (31.3%) patients. Viral decline of at least 2 log 10 (n = 47)

at week 12 was significantly associated with an end-of-treatment (EOT) response.

Eleven early viral response patients were not able to clear HCV RNA, whereas

five patients without a 2 log decline achieved SVR. The highest predictive value

for SVR was an undetectable viremia at week 24 (92%).

Conclusions The outcome of antiviral combination therapy for HCV reinfection

after OLT can be best predicted by week-24 virologic response. The high SVR

rates in patients with detectable HCV RNA at week 12 might suggest a prolonged

treatment protocol in liver transplant recipients.

--------------------------------------------------------------------------------

Sven C. Schmidt

Email: sven.schmidt@...

[Guest guest]

http://www.springerlink.com/content/u64t327p658hn387/

Journal Digestive Diseases and Sciences

Publisher Springer Netherlands

ISSN 0163-2116 (Print) 1573-2568 (Online)

Category Original Article

DOI 10.1007/s10620-009-0982-2

Subject Collection Medicine

SpringerLink Date Friday, October 02, 2009

Original Article

Antiviral Treatment of Patients with Recurrent Hepatitis C After Liver

Transplantation with Pegylated Interferon

Sven C. Schmidt1 , Marcus Bahra1, Bayraktar1, Berg2, Maximilian

Schmeding1, Johann Pratschke1, Neuhaus1 and Ulf Neumann1

(1) Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Charité

Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1,

13353 Berlin, Germany

(2) Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie,

Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger

Platz 1, 13353 Berlin, Germany

Received: 21 February 2009 Accepted: 9 September 2009 Published online: 2

October 2009

Abstract

Background The recurrence of hepatitis C virus (HCV) after liver

transplantation (OLT) leads to recurrent cirrhosis in up to 40% of patients.

Aims To identify patients who profit the most from antiviral therapy and to

delineate whether early treatment after OLT is effective to reach sustained

virological response (SVR), we analyzed factors associated to SVR during

pegylated interferon/ribavirin (PegIFN/RBV) therapy.

Methods A retrospective analysis of efficiency and viral decline kinetics in 83

HCV-infected liver transplant recipients who received therapy with PegIFN/RBV

was carried out.

Results Forty-one of 83 (49.4%) patients became HCV RNA-negative. SVR was

achieved in 26/83 (31.3%) patients. Viral decline of at least 2 log 10 (n = 47)

at week 12 was significantly associated with an end-of-treatment (EOT) response.

Eleven early viral response patients were not able to clear HCV RNA, whereas

five patients without a 2 log decline achieved SVR. The highest predictive value

for SVR was an undetectable viremia at week 24 (92%).

Conclusions The outcome of antiviral combination therapy for HCV reinfection

after OLT can be best predicted by week-24 virologic response. The high SVR

rates in patients with detectable HCV RNA at week 12 might suggest a prolonged

treatment protocol in liver transplant recipients.

--------------------------------------------------------------------------------

Sven C. Schmidt

Email: sven.schmidt@...