Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon ??2b and ribavirin: an open-label series1

Abstract

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.

Recurrencia de la enfermedad hepática primaria después del trasplante hepático

“…La respuesta virológica sostenida (VHC-RNA negativo en suero 6 meses después de completar el tratamiento) con este programa terapéutico en pacientes sin inmunosupresión es de 50-55%; en contraste, en pacientes trasplantados esta respuesta es alrededor de 28% 18,19 . La tendencia actual es tratar la recidiva de la hepatitis C tan pronto hay evidencia de daño hepático en la biopsia hepática, con fibrosis ≥ 2 de 4.…”

HCV recurrence after liver transplantation

“…SVR before transplantation is observed in 50% of all treated cases with HCV-genotype-1 and in 80% with genotypes 2-3 [74]. As long as IFN-α remains the backbone of antiviral therapy, the identification of predictors for the therapy outcome is crucial.…”

“…They are responsible for the intracellular RNA-degradation and the inhibition of RNA-translation. Among all known interferons (IFN-α, IFN-β, Peg-IFN-α2b), pegylated IFN-α2a seems to have the highest antiviral potency, though similar to Peg-IFN-α2b, demonstrating superior treatment results in patients with HCV-re-infection [19,[70][71][72][73][74][75]. Attenuation of renal clearance and improved biochemical stability may explain prolonged half-time and therapeutical advantages observed.…”

Hepatitis C treatment before and after liver transplant

“…Although most recent studies established treatment periods of 48 to 52 weeks, the validity of prolonging treatment in patients who achieved virological response by the end of the standard treatment period is still in question [39][40][41].…”