Peginterferon and Ribavirin in Patients With HCV Cirrhosis After Liver Transplantation

Standard interferon-alpha in combination with ribavirin for hepatitis C patients with advanced liver disease and thrombocytopenia

“…Pegylated IFNs appear to increase the risk of non-respiratory infections independently from neutropenia [17], which may be explained by their distinctive pharmacokinetic differences from standard IFN [23]. A sustained virological response was achieved in three (33.3%) patients, which is similar to previous series with IFN-based therapies in patients with cirrhosis, where HCV eradication rates were between 10% and 30%, especially in HCV genotype non-1 patients (up to 50%) [6,7,15,19,[24][25][26]. However, in view of the low response rates (20%) to antiviral therapy in patients with recurrent disease after liver transplantation or with preemptive antiviral therapy in patients undergoing liver transplantation [21,27], a pre-transplant approach seems to be reasonable.…”

“…The pretreatment CTP grade was A in six patients and B in three. The MELD score was 11 [6][7][8][9][10][11][12][13][14][15][16][17] (median [range]). Three patients were infected with HCV genotype 1b, four with genotype 3a and two with genotype 4.…”

“…Clearance of HCV by antiviral combination therapy before transplantation could avoid recurrence of hepatitis C in the liver allograft, thereby improving survival of both graft and patient [6]. Furthermore, in patients without virological response, IFN therapy may minimize disease progression [7] and decrease the risk of hepatocellular carcinoma [8,9].…”

Managing hepatitis C in liver transplant patients with recurrent infection

“…[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.…”

Antiviral Treatment of Patients with Recurrent Hepatitis C After Liver Transplantation with Pegylated Interferon

“…Pegylated IFNa in combination with RBV significantly improved the antiviral response rates in the treatment of naive patients with chronic HCV infection [12] and have been shown to be safe and effective in liver transplant recipients, reaching sustained virological response (SVR) rates of up to 40% for all genotypes [13][14][15][16][17][18][19][20][21][22]. Antiviral therapies can be conducted pre-OLT, preemptively in the early posttransplant period, and when HCV recurrence has developed.…”