Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon α2b and ribavirin: An open-label series

Hector Rodriguez-Luna, Amer Khatib, Pratima Sharma, Giovanni De Petris, James W. Williams, Jose Ortiz, Kathleen Hansen, David Mulligan, Adyr Moss, David D. Douglas, Vijayan Balan, Jorge Rakela, Hugo E. Vargas

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169 Scopus citations

Abstract

Background. Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is universal. We aimed to evaluate the efficacy and safety of pegylated interferon (PEG-IFN) and ribavirin (RIB) in the treatment of post-OLT HCV recurrence. Methods. Thirty-seven patients with recurrent HCV after OLT were screened and began treatment. Nineteen patients have completed therapy. PEG-IFN was started at a dose of 0.5 μg/kg per week and titrated toward a maximum dose of 1.5 μg/kg per week. RIB was started at a dose of 400 mg per day and titrated toward a maximum of 1000 mg per day, as tolerated. Therapy continued for 1 year after HCV replication was undetectable by reverse transcriptase-polymerase chain reaction and was discontinued if there was no virologic clearance at 48 weeks. Results. Twelve patients (63%) completed the combination regimen. Therapy was discontinued in seven (37%) patients. Seven patients (37%) had undetectable viral load at the end of treatment. Of those, five patients (26%) had sustained viral response 6 months after discontinuation of therapy. Five patients (26%) had no virologic response. Necro-inflammatory score declined from 5.22 to 2.89 (P=0.05) in nonresponders versus 6.8 to 2.6 (P<0.01) in responders. Fibrosis stage did not change in either group. Genotype 1-infected patients had a lower likelihood of attaining end of treatment or sustained viral response (P<0.05 for both). Conclusions. Post-OLT HCV recurrence can be safely treated with PEG-IFN and RIB. Bone marrow toxicity, depression, and rejection are limiting factors that require aggressive management. There was short-term histologic benefit to the use of this regimen, even in those patients without viral clearance.

Original languageEnglish (US)
Pages (from-to)190-194
Number of pages5
JournalTransplantation
Volume77
Issue number2
DOIs
StatePublished - Jan 27 2004

ASJC Scopus subject areas

  • Transplantation

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    Rodriguez-Luna, H., Khatib, A., Sharma, P., De Petris, G., Williams, J. W., Ortiz, J., Hansen, K., Mulligan, D., Moss, A., Douglas, D. D., Balan, V., Rakela, J., & Vargas, H. E. (2004). Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon α2b and ribavirin: An open-label series. Transplantation, 77(2), 190-194. https://doi.org/10.1097/01.TP.0000100481.14514.BB