Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent hepatitis C after liver transplantation

[Guest guest]

doi:10.1016/j.transproceed.2003.10.083 Cite or link using doi

Copyright © 2003 Elsevier Science Inc. All rights reserved.

Liver transplantation: complications

Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent

hepatitis C after liver transplantation

S. Mukherjee, a, J. Roggea, L. Weavera and D. F. Schafera

a Section of Gastroenterology and Hepatology, University of Nebraska Medical

Center, Omaha, Nebraska, USA

Available online 18 December 2003.

Abstract

Recurrent hepatitis C is often treated with an interferon and ribavirin

combination therapy, but the results have been disappointing. Given the

promising results reported with pegylated interferon and ribavirin for

hepatitis C, we were interested in evaluating the effectiveness of this

treatment in liver transplant recipients with recurrent hepatitis C (HCV).

Methods

Between November 2001 and September 2002, patients with recurrent HCV were

screened to determine if they were eligible for treatment. Liver function

tests, HCV-RNA, and liver biopsies were performed on all patients prior to

treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and

6 months after EOT for patients who were HCV-RNA negative at EOT. Patients

were prospectively followed after starting weekly pegylated interferon

alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough,

Kenilworth, NJ, USA) with folic acid 1 mg per day.

Results

Thirty-nine patients eligible for treatment displayed a median age of 50.4

years. Eighteen patients completed treatment, 4 remain on treatment, and 17

were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients

who completed treatment. Side effects led to treatment withdrawal in 17

patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA

eradication occurred in 30.8% of patients.

Conclusion

Side effects are an important limiting factor in the treatment of recurrent

HCV with pegylated interferon and ribavirin. However, these results are

encouraging as sustained HCV eradication occurred in at least 66.7% of

patients who completed treatment. Prospective randomized trials are required

to assess the effectiveness of this treatment and its impact on quality of

life and histology.

Corresponding author. Address reprint requests to Sandeep Mukherjee,

University of Nebraska Medical Center, Section of Gastroenterology and

Hepatology, 983285 Nebraska Medical Center, , Omaha, NE 68198, , USA.

Transplantation Proceedings

Volume 35, Issue 8 , December 2003, Pages 3042-3044

[Guest guest]

doi:10.1016/j.transproceed.2003.10.083 Cite or link using doi

Copyright © 2003 Elsevier Science Inc. All rights reserved.

Liver transplantation: complications

Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent

hepatitis C after liver transplantation

S. Mukherjee, a, J. Roggea, L. Weavera and D. F. Schafera

a Section of Gastroenterology and Hepatology, University of Nebraska Medical

Center, Omaha, Nebraska, USA

Available online 18 December 2003.

Abstract

Recurrent hepatitis C is often treated with an interferon and ribavirin

combination therapy, but the results have been disappointing. Given the

promising results reported with pegylated interferon and ribavirin for

hepatitis C, we were interested in evaluating the effectiveness of this

treatment in liver transplant recipients with recurrent hepatitis C (HCV).

Methods

Between November 2001 and September 2002, patients with recurrent HCV were

screened to determine if they were eligible for treatment. Liver function

tests, HCV-RNA, and liver biopsies were performed on all patients prior to

treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and

6 months after EOT for patients who were HCV-RNA negative at EOT. Patients

were prospectively followed after starting weekly pegylated interferon

alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough,

Kenilworth, NJ, USA) with folic acid 1 mg per day.

Results

Thirty-nine patients eligible for treatment displayed a median age of 50.4

years. Eighteen patients completed treatment, 4 remain on treatment, and 17

were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients

who completed treatment. Side effects led to treatment withdrawal in 17

patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA

eradication occurred in 30.8% of patients.

Conclusion

Side effects are an important limiting factor in the treatment of recurrent

HCV with pegylated interferon and ribavirin. However, these results are

encouraging as sustained HCV eradication occurred in at least 66.7% of

patients who completed treatment. Prospective randomized trials are required

to assess the effectiveness of this treatment and its impact on quality of

life and histology.

Corresponding author. Address reprint requests to Sandeep Mukherjee,

University of Nebraska Medical Center, Section of Gastroenterology and

Hepatology, 983285 Nebraska Medical Center, , Omaha, NE 68198, , USA.

Transplantation Proceedings

Volume 35, Issue 8 , December 2003, Pages 3042-3044

[Guest guest]

doi:10.1016/j.transproceed.2003.10.083 Cite or link using doi

Copyright © 2003 Elsevier Science Inc. All rights reserved.

Liver transplantation: complications

Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent

hepatitis C after liver transplantation

S. Mukherjee, a, J. Roggea, L. Weavera and D. F. Schafera

a Section of Gastroenterology and Hepatology, University of Nebraska Medical

Center, Omaha, Nebraska, USA

Available online 18 December 2003.

Abstract

Recurrent hepatitis C is often treated with an interferon and ribavirin

combination therapy, but the results have been disappointing. Given the

promising results reported with pegylated interferon and ribavirin for

hepatitis C, we were interested in evaluating the effectiveness of this

treatment in liver transplant recipients with recurrent hepatitis C (HCV).

Methods

Between November 2001 and September 2002, patients with recurrent HCV were

screened to determine if they were eligible for treatment. Liver function

tests, HCV-RNA, and liver biopsies were performed on all patients prior to

treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and

6 months after EOT for patients who were HCV-RNA negative at EOT. Patients

were prospectively followed after starting weekly pegylated interferon

alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough,

Kenilworth, NJ, USA) with folic acid 1 mg per day.

Results

Thirty-nine patients eligible for treatment displayed a median age of 50.4

years. Eighteen patients completed treatment, 4 remain on treatment, and 17

were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients

who completed treatment. Side effects led to treatment withdrawal in 17

patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA

eradication occurred in 30.8% of patients.

Conclusion

Side effects are an important limiting factor in the treatment of recurrent

HCV with pegylated interferon and ribavirin. However, these results are

encouraging as sustained HCV eradication occurred in at least 66.7% of

patients who completed treatment. Prospective randomized trials are required

to assess the effectiveness of this treatment and its impact on quality of

life and histology.

Corresponding author. Address reprint requests to Sandeep Mukherjee,

University of Nebraska Medical Center, Section of Gastroenterology and

Hepatology, 983285 Nebraska Medical Center, , Omaha, NE 68198, , USA.

Transplantation Proceedings

Volume 35, Issue 8 , December 2003, Pages 3042-3044

[Guest guest]

doi:10.1016/j.transproceed.2003.10.083 Cite or link using doi

Copyright © 2003 Elsevier Science Inc. All rights reserved.

Liver transplantation: complications

Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent

hepatitis C after liver transplantation

S. Mukherjee, a, J. Roggea, L. Weavera and D. F. Schafera

a Section of Gastroenterology and Hepatology, University of Nebraska Medical

Center, Omaha, Nebraska, USA

Available online 18 December 2003.

Abstract

Recurrent hepatitis C is often treated with an interferon and ribavirin

combination therapy, but the results have been disappointing. Given the

promising results reported with pegylated interferon and ribavirin for

hepatitis C, we were interested in evaluating the effectiveness of this

treatment in liver transplant recipients with recurrent hepatitis C (HCV).

Methods

Between November 2001 and September 2002, patients with recurrent HCV were

screened to determine if they were eligible for treatment. Liver function

tests, HCV-RNA, and liver biopsies were performed on all patients prior to

treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and

6 months after EOT for patients who were HCV-RNA negative at EOT. Patients

were prospectively followed after starting weekly pegylated interferon

alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough,

Kenilworth, NJ, USA) with folic acid 1 mg per day.

Results

Thirty-nine patients eligible for treatment displayed a median age of 50.4

years. Eighteen patients completed treatment, 4 remain on treatment, and 17

were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients

who completed treatment. Side effects led to treatment withdrawal in 17

patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA

eradication occurred in 30.8% of patients.

Conclusion

Side effects are an important limiting factor in the treatment of recurrent

HCV with pegylated interferon and ribavirin. However, these results are

encouraging as sustained HCV eradication occurred in at least 66.7% of

patients who completed treatment. Prospective randomized trials are required

to assess the effectiveness of this treatment and its impact on quality of

life and histology.

Corresponding author. Address reprint requests to Sandeep Mukherjee,

University of Nebraska Medical Center, Section of Gastroenterology and

Hepatology, 983285 Nebraska Medical Center, , Omaha, NE 68198, , USA.

Transplantation Proceedings

Volume 35, Issue 8 , December 2003, Pages 3042-3044