Pegylated interferon α‐2b plus ribavirin in the treatment of post‐liver transplant recurrent hepatitis C

Abstract

Treatment of recurrent HCV infection with combination of IFN or PEG-IFN and RBV produced an on-therapy VR in 29% and BR in 65% of patients. Hematologic toxicity and dose modifications were frequent. Our experience with antiviral therapy for HCV post-OLT remains disappointing but PEG-IFN + RBV appears to produce VR in a sizable portion of IFN + RBV non-responders.

Survival of Liver Transplant Patients Coinfected with HIV and HCV Is Adversely Impacted by Recurrent Hepatitis C

“…The over 3 year survival in five of these subjects indicate that although some co-infected patients may develop a rapid course of recurrent hepatitis C after LTx, there is a subset of patients who experience a less aggressive clinical course of HCV infection, although there were no predictors of such outcomes. It is also noteworthy that the overall VR rate to interferon-a and ribavirin therapy in coinfected patients (40%) is similar to response rates reported in the nonHIV population (39)(40)(41). In addition, our observation was that coinfected patients as well as non-HIV patients tolerated HCV treatment.…”

Managing hepatitis C in liver transplant patients with recurrent infection

“…The best results were obtained with pegylated interferon (PEG-IFN) alfa in combination with ribavirin, with higher SVR rates compared to IFN or ribavirin monotherapies. 93 One of the main problems is to find the individual balance between tolerable and manageable side effects and maintain therapy over the whole time of treatment to maximize the number of SVR and minimize the number of relapsers.…”

“…[93][94][95][96]98,99,102,105,106,109,110,127,145,146 Most published studies are uncontrolled trials with a high variability in patient selection, and type and timing of antiviral therapy. Rates of SVR have been less than those achieved in the nontransplant setting.…”

“…The current SVR rate with this regimen is 30%, ranging from 12% to 43% in small studies. [93][94][95][96]100,101,104,105 A meta-analysis from over 40 treatment trials estimated that SVR rates of combination therapy were 24% and 27%. 147 A recent systematic review of predominantly therapeutic intervention studies by Berenguer et al confirmed that 30.2% of patients treated with PEG-IFN plus ribavirin will attain SVR.…”

Recurrent Hepatitis C Virus Infection and Outcome After Living-Donor Liver Transplant

“…Combination therapy in liver transplant patients may be associated with frequent and severe adverse events, including the frequent need for erythropoietin and/or filgrastim. [26][27][28][29] All patients in the present study required supportive treatment with erythropoietin and/or filgrastim. The frequency of treatment discontinuation because of adverse events was 39% in the present study, higher than 16% reported in immunocompetent subjects with significant severity.…”