March 22, 2014

Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C

Dig Liver Dis. 2014 Mar 10. pii: S1590-8658(14)00207-2. doi: 10.1016/j.dld.2014.01.157. [Epub ahead of print]

Ponziani FR1, ViganĂ² R2, Iemmolo RM3, Donato MF4, Rendina M5, Toniutto P6, Pasulo L7, Morelli MC8, Burra P9, Miglioresi L10, Merli M11, Di Paolo D12, Fagiuoli S7, Gasbarrini A13, Pompili M13; on behalf of AISF RECOLT-C Group, Belli L, Gerunda GE, Marino M,Montalti R, Di Benedetto F, De Ruvo N, Rigamonti C, Colombo M, Rossi G, Di Leo A, Lupo L, Memeo V, Bringiotti R, Zappimbulso M,Bitetto D, Vero V, Colpani M, Fornasiere E, Pinna AD, Morelli MC, Bertuzzo V, De Martin E, Senzolo M, Ettorre GM, Visco-Comandini U,Antonucci G, Angelico M, Tisone G, Giannelli V, Giusto M.


BACKGROUND: The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival.

AIM: To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis Crecurrence.

METHODS: 436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis Crecurrence were retrospectively evaluated.

RESULTS: The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008).

CONCLUSIONS: Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.

Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

KEYWORDS: HCV antiviral treatment, Hepatitis C recurrence, Liver transplantation, Sustained viral response

PMID: 24635906 [PubMed - as supplied by publisher]


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