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Ribavirin/interferon-alpha sequential treatment of recurrent hepatitis C after liver transplantation

Kullak-Ublick, Gerd A
Keller, Walter
Fried, Ronald
Vanlemmens, Claire
Kraehenbuhl, Stephan
Egger, Hans-Peter
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Published in Transplant International. 2004, vol. 17, no. 4, p. 169-76
Abstract Hepatitis C virus (HCV) infection invariably recurs after liver transplantation (LT), and sequels of chronic hepatitis of the graft are a significant cause of morbidity and mortality. In an uncontrolled trial, 31 patients with histologically confirmed hepatitis C after LT received, sequentially, ribavirin (10 mg/kg body weight q.d.) for 12 weeks, followed by ribavirin at the same dose q.d. plus interferon-alpha (IFN-alpha) [3 million units three times a week (3 MU TIW)] for another 48 weeks. Based on an intent-to-treat analysis, the percentages of patients with undetectable HCV RNA in their serum were 0%, 38.7% and 45.2% after 12, 36 and 60 weeks of therapy, respectively. A sustained virological response, as defined by undetectable serum HCV RNA 24 weeks after the end of treatment, was observed in 9/31 patients (29%). Sustained responders had a significant improvement of their liver inflammatory activity score (P=0.025), but not of their liver fibrosis score. The chances of sustained virological response correlated with the length of treatment, but not with the HCV genotype or baseline HCV RNA level. In conclusion, patients with recurrent hepatitis C after LT might benefit from ribavirin/IFN-alpha therapy, provided that the treatment is tolerated for a sufficient duration of time.
Keywords AdultAgedAntiviral Agents/administration & dosageDrug Administration ScheduleDrug Therapy, CombinationFemaleHepacivirus/genetics/isolation & purificationHepatitis C/drug therapy/pathologyHepatitis C, Chronic/prevention & controlHumansInterferon-alpha/administration & dosageLiver Transplantation/adverse effectsMaleMiddle AgedRNA, Viral/bloodRecurrenceRibavirin/administration & dosageSeverity of Illness IndexTime FactorsTreatment OutcomeViral Load
PMID: 15060764
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Research groups Hépatologie chirurgicale (327)
Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Etudes et traitement de l'hépatite C et B (554)
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GIOSTRA, Emiliano et al. Ribavirin/interferon-alpha sequential treatment of recurrent hepatitis C after liver transplantation. In: Transplant International, 2004, vol. 17, n° 4, p. 169-76. doi: 10.1007/s00147-004-0695-6 https://archive-ouverte.unige.ch/unige:37182

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Deposited on : 2014-06-04

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