Treatment of genotype-1 hepatitis C recurrence after liver transplant improves survival in both sustained responders and relapsers

Alessandro Milani, Antonio Gasbarrini, Maurizio Pompili, Francesca Romana Ponziani, Raffaella Zaccaria, Raffaella Viganò, Rosa Maria Iemmolo, Maria Francesca Donato, Maria Rendina, Pierluigi Toniutto, Luisa Pasulo, Matteo Cescon, Patrizia Burra, Lucia Miglioresi, Manuela Merli, Daniele Di Paolo, Stefano Fagiuoli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

7 Citazioni (Scopus)

Abstract

The aim of this study was to evaluate the factors affecting the response to treatment and how it could affect survival in a large series of genotype-1 HCV-transplanted patients. Three-hundred and twenty six genotype-1 HCV patients were enrolled. One hundred and ninety-six patients (60.1%) were nonresponders and 130 (39.9%) showed negative HCV-RNA at the end of treatment. Eighty-four of them (25.8%) achieved sustained virological response, while 46 (14.1%) showed viral relapse. Five-year cumulative survival was significantly worse in nonresponders (76.4%) compared with sustained viral response (93.2) or relapsers (94.9%). Sustained responders and relapsers were therefore considered as a single 'response group' in further analysis. Pretreatment variables significantly associated with virological response at multivariate regression analysis were the absence of ineffective pretransplant antiviral therapy, the recurrence of HCV-hepatitis more than 1 year after transplant, an histological grading ≥4 at pretreatment liver biopsy, a pretreatment HCV-RNA level <1.2 × 10(6 ) IU/ml, and the absence of diabetes. As expected, also on-treatment variables (rapid and early virological response) were significantly associated to the response to antiviral treatment. In conclusion, this study shows that postliver transplant antiviral treatment results in beneficial effect on survival not only in sustained responders but also in relapsers.
Lingua originaleEnglish
pagine (da-a)281-289
Numero di pagine9
RivistaTransplant international : official journal of the European Society for Organ Transplantation
Volume26
DOI
Stato di pubblicazionePubblicato - 2013

Keywords

  • Antiviral Agents
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Genotype
  • Graft Rejection
  • Graft Survival
  • Hepatitis C, Chronic
  • Humans
  • Interferon-alpha
  • Italy
  • Kaplan-Meier Estimate
  • Liver Transplantation
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polyethylene Glycols
  • Predictive Value of Tests
  • Recombinant Proteins
  • Recurrence
  • Regression Analysis
  • Retreatment
  • Retrospective Studies
  • Ribavirin
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome

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