Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin: Lessons on tolerability and efficacy

Kozhikode V. Narayanan Menon, John J. Poterucha, Omer M. El-Amin, Lawrence J. Burgart, Walter K Kremers, Charles B. Rosen, Russell H. Wiesner, Michael Charlton

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Recurrence of hepatitis C virus (HCV) infection after orthotopic liver transplantation is a major cause of graft failure. The aim of our study was to determine the safety, efficacy, and tolerability of combination therapy with interferon and ribavirin in the treatment of recurrent hepatitis after liver transplantation. Twenty-six patients (18 men) with histologically established HCV recurrence after liver transplantation for cirrhosis secondary to chronic HCV infection were treated with a combination of interferon alfa-2b (3 million units three times weekly) and ribavirin (800 to 1,000 mg/d). Dosage modifications were according to a standard protocol incorporating laboratory values and clinical side effects. Fifty percent of patients completed 1 year or more of therapy. On an intention-to-treat basis, nine patients (35%) showed an end-of-treatment virological response. Six of these nine patients completed greater than 6 additional months of follow-up, and all have had sustained virological responses. A histological response (decrease in histological activity index ≥ 2) was seen in 75% of virological responders and 67% of nonresponders. Adverse events requiring dose modification or cessation of therapy occurred in 66% of patients. Adjuvant therapies used to support hemoglobin levels included erythropoietin and red blood cell transfusions. There were no independent pretreatment predictors of a virological response, perhaps because of the small sample size. Combination therapy with interferon and ribavirin may be beneficial in patients with recurrent HCV after liver transplantation. The majority of patients require dose modifications because of side effects. Histological response is common in virological nonresponders.

Original languageEnglish (US)
Pages (from-to)623-629
Number of pages7
JournalLiver Transplantation
Volume8
Issue number7
DOIs
StatePublished - 2002

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Ribavirin
Hepatitis C
Interferons
Recurrence
Hepacivirus
Liver Transplantation
interferon alfa-2b
Virus Diseases
Therapeutics
Erythrocyte Transfusion
Chronic Hepatitis C
Erythropoietin
Liver Cirrhosis
Sample Size
Hepatitis
Hemoglobins
Transplants
Safety

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin : Lessons on tolerability and efficacy. / Narayanan Menon, Kozhikode V.; Poterucha, John J.; El-Amin, Omer M.; Burgart, Lawrence J.; Kremers, Walter K; Rosen, Charles B.; Wiesner, Russell H.; Charlton, Michael.

In: Liver Transplantation, Vol. 8, No. 7, 2002, p. 623-629.

Research output: Contribution to journalArticle

Narayanan Menon, KV, Poterucha, JJ, El-Amin, OM, Burgart, LJ, Kremers, WK, Rosen, CB, Wiesner, RH & Charlton, M 2002, 'Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin: Lessons on tolerability and efficacy', Liver Transplantation, vol. 8, no. 7, pp. 623-629. https://doi.org/10.1053/jlts.2002.33968
Narayanan Menon, Kozhikode V. ; Poterucha, John J. ; El-Amin, Omer M. ; Burgart, Lawrence J. ; Kremers, Walter K ; Rosen, Charles B. ; Wiesner, Russell H. ; Charlton, Michael. / Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin : Lessons on tolerability and efficacy. In: Liver Transplantation. 2002 ; Vol. 8, No. 7. pp. 623-629.
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