Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination

Dumortier, Jérôme; Scoazec, Jean‐Yves; Chevallier, Philippe; Boillot, Olivier

doi:10.1016/j.jhep.2003.12.015

Cited by 213 publications

(193 citation statements)

References 28 publications

Supporting

Mentioning

177

Contrasting

Unclassified

Order By: Relevance

“…Treatment was withdrawn in four patients (20%) and the dose of PEG IFN and of RBV was reduced for six and 13 patients, respectively. 12 These observations are not only in agreement with our results but also emphasize the difficulty in obtaining a sustained virological response in such patients, mainly because of treatment discontinuation because of adverse events, and also partly because of difficulty in attaining a strong immune response. 13 Unfortunately, little has been published specifically concerning the treatment of HCV-infected SCT recipients.…”

Section: Discussionsupporting

confidence: 92%

Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients

Latour

Asselah

Lévy

et al. 2005

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:We recently reported an increased incidence of cirrhosis in hepatitis C virus (HCV)-infected stem cell transplant (SCT) recipients. Here, we describe our experience in the treatment of these patients, which has been, to date, poorly reported in the literature. Among 99 HCV-infected HCT recipients, 36 had HCV-related liver lesions on biopsy requiring therapy. Owing to HCV treatment contraindications, only 61% of patients (22/36) could be treated. In all, 12 patients received more than one course of anti-HCV treatment if they had HCV RNA still detectable after the first course of treatment and no treatment contraindications. Combined therapy (pegylated interferon (IFN): n ¼ 9, or standard IFN: n ¼ 9, in combination with ribavirin) led to sustained virological response in 4/18 (20%) patients as compared to 2/20 (10%) in patients who received IFN alone. Hematological toxicity was more frequent with combined therapy. While anemia responded to erythropoietin and/or dose modification, thrombocytopenia usually led to treatment interruption (n ¼ 3). This study thus highlights the efficacy of combined therapy and emphasizes the fact that the undue safety concerns are not a problem when treating this particular population.

show abstract

Section: Discussionsupporting

confidence: 92%

Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients

Latour

Asselah

Lévy

et al. 2005

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…[5][6][7] The lower rate of SVR compared to nontransplant HCV patients can be attributed to several factors including differences in the HCV dynamics between the immunocompetent and immunocompromised hosts, 20,21 higher prevalence of insulin resistance in LT recipients, and lower tolerability of PEG/RBV. 22,23 Consistent with the treatment of chronic nontransplantation HCV infection, genotypes other than 1 were associated with a significantly higher rate of SVR. Similarly, a strong statistical trend was observed toward a higher SVR in LT patients with low pretreatment HCV RNA.…”

Section: Discussionmentioning

confidence: 97%

Recurrent hepatitis C after liver transplantation: On-treatment prediction of response to peginterferon/ribavirin therapy

et al. 2007

View full text Add to dashboard Cite

Sustained virologic response (SVR) in the treatment of recurrent hepatitis C virus (HCV) infection after liver transplantation (LT) remains suboptimal. We evaluated efficacy of pegylated interferon alfa (PEG) and ribavirin (RBV) (PEG/RBV) combination therapy in LT recipients with recurrent HCV and predictive values of rapid virological response (RVR) and early virologic response (EVR). Between January 2001 and October 2005, LT recipients with recurrent HCV were intended to be treated for 48 weeks with PEG/RBV combination therapy independent of genotype or virologic response [53 patients (79% genotype 1)]. On-treatment predictor of response at week 4 (RVR) was defined as undetectable HCV RNA, and at week 12 (EVR) as undetectable HCV RNA or a Ͼ2 log 10 drop from pretreatment viral load. SVR was seen in 19 (35%) patients. Patients with genotype 2/3 were more likely to achieve SVR than those with genotype 1 (87% versus 23%; P ϭ 0.001). The highest rate of SVR was seen in patients with RVR [specificity and positive predictive value (PPV) ϭ 100%] while the highest rate of treatment failure was seen in those who did not have EVR [sensitivity and negative predictive value (NPV) ϭ 100%]. The NPV of RVR to identify those who will not achieve SVR was also very high (88%). EVR had low PPV (63%) to identify those with SVR. In conclusion, PEG/RBV combination therapy is effective in the treatment of post-LT recurrent HCV. On-treatment virologic monitoring is highly predictive of SVR and may optimize the virologic response and minimize toxicity. Given its high PPV and NPV, RVR appears to be the most appropriate decision time point for continuation of therapy.

show abstract

“…Recent studies suggest that ACR develops due to decreasing levels of immunosuppressive drugs after viral clearance and subsequent improvement of hepatic microsomal function. Reported rejection rates vary in respect to the study design, being lower in randomized controlled trials (0-5%) [Chalasani et al, 2005;Samuel et al, 2003) and as high as 35% in uncontrolled trials (Dumortier et al, 2004;Sharma et al, 2007;Stravitz et al, 2004). Berenguer M et al reported trend towards higher rejection rate on pegylated IFN in comparison with standard treatment (Berenguer et al, 2006b).…”

Section: Treatment Of Established Recurrent Hcv Hepatitismentioning

confidence: 99%

Management of Recurrent HCV and HBV Infections after Liver Transplantation

Wawrzynowicz‐Syczewska¹

2012

Liver Transplantation - Basic Issues

View full text Add to dashboard Cite

Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination

Cited by 213 publications

References 28 publications

Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients

Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients

Recurrent hepatitis C after liver transplantation: On-treatment prediction of response to peginterferon/ribavirin therapy

Management of Recurrent HCV and HBV Infections after Liver Transplantation

Contact Info

Product

Resources

About