Clinical characterization of patients developing histologically‐proven fibrosing cholestatic hepatitis C post‐liver transplantation

Satapathy, Sanjaya K.; Sclair, Seth N.; Fiel, M. Isabel; Marti, Josep; Schiano, Thomas D.

doi:10.1111/j.1872-034x.2011.00781.x

Cited by 53 publications

(51 citation statements)

References 37 publications

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“…15 The median time to presentation of FCH has been reported as 7.6 months after transplant. 7 In our series, all four cases presented within 6 months after transplant. Three of four patients had itching as a predominant symptom (all 3 with FCH had itching).…”

Section: Discussionmentioning

confidence: 89%

“…4 A proportion of patients (2-14%) who undergo liver or kidney transplant develop early severe recurrence (classically defined as within 6 months of transplant). [5][6][7] The most aggressive form of HCV recurrence presents as cholestatic hepatitis (also called fibrosing cholestatic hepatitis [FCH]). Treatment of severe HCV recurrence with Pegylated Interferon (PEG-interferon) and ribavirin was associated with low response, high rate of adverse effects, and an associated mortality of up to 81%.…”

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confidence: 99%

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Early Acute Severe HCV Recurrence After Transplantation: From Universal Mortality to Cure

Wadhawan¹,

Vij

Makki

et al. 2017

Journal of Clinical and Experimental Hepatology

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Acute severe recurrence of hepatitis C virus (HCV) after solid organ transplant is associated with high mortality. Pegylated interferon and ribavirin are suboptimal in treatment of this severe form of recurrence. We report 4 cases of acute severe HCV recurrence (within 6 months after transplant), including 3 cases with fibrosing cholestatic hepatitis treated with sofosbuvir and ribavirin. All four patients achieved a rapid suppression of HCV RNA with a normalization of liver function tests within 4 weeks of starting therapy. All patients were HCV RNA negative at 12 weeks after stopping therapy. The combination was found to be safe as anemia was the only adverse effect, which developed in 2 patients (1 patient required blood transfusion, while another managed with erythropoietin). Sofosbuvir and ribavirin appear to be safe and efficacious in treatment of acute severe HCV recurrence after organ transplant. ( J CLIN EXP HEPATOL 2017;7:28-32)

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Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 99%

Early Acute Severe HCV Recurrence After Transplantation: From Universal Mortality to Cure

Wadhawan¹,

Vij

Makki

et al. 2017

Journal of Clinical and Experimental Hepatology

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“…Treatment with combination Peg-IFN and RBV is often poorly tolerated after transplantation, and has been associated with poor SVR rates of approximately 30% [67] . For those who do not tolerate therapy with evidence of active hepatitis and disease progression, those who do not respond to therapy with evidence of disease progression, and those with severe fibrosing cholestatic hepatitis, the rate of graft failure is high, leading to graft decompensation and death or retransplantation [68,69] . Treatment with DAAs has been shown to improve significantly the SVR rates in post transplant patients.…”

Section: Resultsmentioning

confidence: 99%

Era of direct acting antivirals in chronic hepatitis C: Who will benefit?

Fung

2015

WJH

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In the era of highly effective direct acting antiviral (DAA) drugs for the treatment of chronic hepatitis C (CHC) infection, where eradication is almost ensured with minimal side effects, all hepatitis C carriers should benefit theoretically. In the real world setting however, only a small proportion will benefit at this time point due to the multiple barriers to accessing therapy. Given that universal treatment is unlikely, treatment with DAAs will likely be restricted to those with the highest health benefits, and for those who can afford the high expense of a treatment course. Those with the highest unmet needs include those who have failed previous interferon-based therapy or who are interferon-ineligible with evidence of active disease, those with advance liver disease, and those with recurrence of hepatitis C after liver transplantation. In the future, the focus should be on increasing access to treatment for those infected with CHC.

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“…FCH is characterized by a high viral load and divergent quasispecies (37). FCH results in progressive liver dysfunction and its prognosis is poor with more than 90% mortality (38,39).…”

Section: Fibrosing Cholestatic Hepatitismentioning

confidence: 99%

Direct-acting agents for hepatitis C virus before and after liver transplantation

Sugawara

Hibi

2017

BST

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Clinical characterization of patients developing histologically‐proven fibrosing cholestatic hepatitis C post‐liver transplantation

Cited by 53 publications

References 37 publications

Early Acute Severe HCV Recurrence After Transplantation: From Universal Mortality to Cure

Early Acute Severe HCV Recurrence After Transplantation: From Universal Mortality to Cure

Era of direct acting antivirals in chronic hepatitis C: Who will benefit?

Direct-acting agents for hepatitis C virus before and after liver transplantation

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