Sustained virologic response to therapy of recurrent hepatitis C after liver transplantation is related to early virologic response and dose adherence

Pratima Sharma, Jorge A. Marrero, Robert J. Fontana, Joel K. Greenson, Hari Conjeevaram, Grace L. Su, Frederick Askari, Patricia Sullivan, Anna S. Lok

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Sustained virologic response (SVR) after antiviral therapy for recurrent hepatitis C virus (HCV) infection in liver transplant (LT) recipients is consistently lower than that achieved in non-LT patients. We evaluated efficacy and safety of pegylated interferon (IFN) and ribavirin (RBV) therapy in LT recipients with recurrent HCV and factors associated with SVR. All subjects with histologic evidence of recurrent HCV were intended to be treated for 48 weeks with full-dose pegylated IFN; target dose of RBV was 800 mg/day. Thirty-five LT recipients with recurrent HCV, median age 48.5 years, 77% genotype 1, and median pretreatment HCV RNA 6.4 log10 IU/mL were treated between January 2000 and February 2006. Antiviral therapy was discontinued prematurely in 15 subjects as a result of adverse events. Median overall treatment duration was 46 weeks. Early virologic response at week 12 was seen in 17 (49%) and an end-of-treatment virological response in 19 (54%) patients. SVR was achieved in 13 patients (37%), and all 9 patients followed for > 1 year after treatment had durable response. Patients with SVR had significantly lower pretreatment HCV RNA (5.7 vs. 6.5 log10 IU/mL, P = 0.003), more likely to have a week 12 virological response (85% vs. 27%, P = 0.0009) and received higher cumulative doses of pegylated IFN (75% vs. 33%, P = 0.029) and RBV (90% vs. 26%, P = 0.016) compared with patients whose disease did not respond to therapy. In conclusion, SVR was achieved in 37% of patients with recurrent hepatitis C after LT. Similar to non-LT patients, those with lower pretreatment HCV RNA, a week 12 virological response, and pegylated IFN and RBV dose adherence were more likely to achieve SVR.

Original languageEnglish (US)
Pages (from-to)1100-1108
Number of pages9
JournalLiver Transplantation
Volume13
Issue number8
DOIs
StatePublished - Aug 2007

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Hepatitis C
Liver Transplantation
Hepacivirus
Ribavirin
Interferons
Liver
RNA
Therapeutics
Transplants
Antiviral Agents
Sustained Virologic Response
Virus Diseases
Genotype
Safety
Transplant Recipients

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Sustained virologic response to therapy of recurrent hepatitis C after liver transplantation is related to early virologic response and dose adherence. / Sharma, Pratima; Marrero, Jorge A.; Fontana, Robert J.; Greenson, Joel K.; Conjeevaram, Hari; Su, Grace L.; Askari, Frederick; Sullivan, Patricia; Lok, Anna S.

In: Liver Transplantation, Vol. 13, No. 8, 08.2007, p. 1100-1108.

Research output: Contribution to journalArticle

Sharma, Pratima ; Marrero, Jorge A. ; Fontana, Robert J. ; Greenson, Joel K. ; Conjeevaram, Hari ; Su, Grace L. ; Askari, Frederick ; Sullivan, Patricia ; Lok, Anna S. / Sustained virologic response to therapy of recurrent hepatitis C after liver transplantation is related to early virologic response and dose adherence. In: Liver Transplantation. 2007 ; Vol. 13, No. 8. pp. 1100-1108.
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abstract = "Sustained virologic response (SVR) after antiviral therapy for recurrent hepatitis C virus (HCV) infection in liver transplant (LT) recipients is consistently lower than that achieved in non-LT patients. We evaluated efficacy and safety of pegylated interferon (IFN) and ribavirin (RBV) therapy in LT recipients with recurrent HCV and factors associated with SVR. All subjects with histologic evidence of recurrent HCV were intended to be treated for 48 weeks with full-dose pegylated IFN; target dose of RBV was 800 mg/day. Thirty-five LT recipients with recurrent HCV, median age 48.5 years, 77{\%} genotype 1, and median pretreatment HCV RNA 6.4 log10 IU/mL were treated between January 2000 and February 2006. Antiviral therapy was discontinued prematurely in 15 subjects as a result of adverse events. Median overall treatment duration was 46 weeks. Early virologic response at week 12 was seen in 17 (49{\%}) and an end-of-treatment virological response in 19 (54{\%}) patients. SVR was achieved in 13 patients (37{\%}), and all 9 patients followed for > 1 year after treatment had durable response. Patients with SVR had significantly lower pretreatment HCV RNA (5.7 vs. 6.5 log10 IU/mL, P = 0.003), more likely to have a week 12 virological response (85{\%} vs. 27{\%}, P = 0.0009) and received higher cumulative doses of pegylated IFN (75{\%} vs. 33{\%}, P = 0.029) and RBV (90{\%} vs. 26{\%}, P = 0.016) compared with patients whose disease did not respond to therapy. In conclusion, SVR was achieved in 37{\%} of patients with recurrent hepatitis C after LT. Similar to non-LT patients, those with lower pretreatment HCV RNA, a week 12 virological response, and pegylated IFN and RBV dose adherence were more likely to achieve SVR.",
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