Treatment of recurrent hepatitis C in liver transplants: efficacy of a six versus a twelve month course of interferon alfa 2b with ribavirin

Lavezzo, Bruna; Franchello, A; Smedile, A.; David, Ezio; Barbui, Anna Maria; Torrani, M.; Ottobrelli, A.; Zamboni, Fausto; Fadda, M.; Bobbio, A; Salizzoni, Mauro

doi:10.1016/s0168-8278(02)00109-5

Cited by 111 publications

(85 citation statements)

References 10 publications

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“…27,28) The disease progression of hepatitis C is faster in graft liver than in healthy liver, 8,9) and the rate of SVR is lower in transplant patients than in patients who did not receive liver transplants. 29) In this study, all patients completed the 12-week TVR triple therapy. In all patients, the HCV RNA levels immediately decreased to the baseline levels ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

Successful Telaprevir Treatment in Combination of Cyclosporine against Recurrence of Hepatitis C in the Japanese Liver Transplant Patients

Kikuchi

Okuda

Ueda

et al. 2014

Biological & Pharmaceutical Bulletin

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Telaprevir (TVR) is a protease inhibitor used in combination with pegylated interferon alfa-2b and ribavirin for hepatitis C, and TVR strongly inhibits CYP3A4 and CYP3A5. We reported successful TVR treatment of liver transplant patients with recurrence of hepatitis C during receiving immunosuppressive therapy. Before initiation of triple therapy, all patients switched from tacrolimus to cyclosporine, which has a lower inhibitory effect on CYP3A4 and CYP3A5 than tacrolimus. To avoid graft failure, we measured the cyclosporine blood concentrations at 0, 2, and 6 h after administration to maintain the target level (150-200 ng/ mL) within 1 week after initiation of TVR and adjusted the dose of cyclosporine. The dose of cyclosporine was decreased 0.24-0.40 fold in all patients after initiation of TVR treatment. In 3 patients, the dose of TVR was decreased two-thirds of starting dose because of adverse effects, including anorexia and skin rash. However, the HCV RNA level rapidly decreased to undetectable levels within 1 month. Furthermore, all patients completed the TVR therapy in 12 weeks and did not experience liver graft rejection. In addition, we found the rapid elimination of inhibitory effect of TVR on the disposition of cyclospirne in the all four cases and therefore, rapid increase in the dosage of cyclosporine would be required immediately after the end of TVR administration. These results suggest that frequent measurement of cyclosporine levels was important for successful TVR triple therapy and prevention of rejection.

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Section: Discussionmentioning

confidence: 99%

Successful Telaprevir Treatment in Combination of Cyclosporine against Recurrence of Hepatitis C in the Japanese Liver Transplant Patients

Kikuchi

Okuda

Ueda

et al. 2014

Biological & Pharmaceutical Bulletin

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“…Adverse effects can prompt premature treatment discontinuation in up to 50% of patients [71]. HCV infection also increases the risk of death among dialysis patients up to 2.39 -fold [72] and increases mortality rates among transplant recipients [73]. IFN monotherapy is the treatment of choice in HCV positive dialysis patients awaiting transplantation [74].…”

Section: Liver and Kidney Transplantationmentioning

confidence: 99%

Hepatitis C virus resistance to interferon therapy: an alarming situation

Kanwal¹,

Mahmood

2014

Open Life Sciences

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Hepatitis C virus is presently a major public health problem across the globe. The main objective in treating hepatitis C virus (HCV) infection is to achieve a sustained virological response (SVR). Interferon-α (IFN-α) and pegylated interferon (PegIFN) in combination with Ribavirin (RBV) are the choice of treatment nowadays against chronic hepatitis C. There are several mechanisms evolved by the hepatitis C virus that facilitate the persistence of virus and further lead the patient’s status as non responder. Various factors involved in patient’s lack ofresponse to the therapy include: (1) viral factors, (2) host factors, (3) molecular mechanisms related to the lack of response and (4) social factors. Herein we have made an attempt to summarize all the related predictors of drug resistance in one article so that the future polices can be planned to overcome this obstacle and potential therapies can be designed by considering these factors.

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“…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].…”

Section: Post-transplant Treatmentmentioning

confidence: 99%