Impact of pegylated interferon α-2B and ribavirin on hepatic fibrosis in liver transplant patients with recurrent hepatitis C

An open-label series

Sandeep Mukherjee, Elizabeth Lyden

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Patients with recurrent hepatitis C virus (HCV) are often treated with interferon-based therapy in an attempt to eradicate HCV and prevent cirrhosis requiring retransplantation. We describe our experience with pegylated interferon and ribavirin and the impact of this therapy on hepatic fibrosis. Methods: Patients were treated with pegylated interferon α-2b 1.5mcg/kg/week and ribavirin 800mg/day for 6-12 months according to genotype. HCV ribonucleic acid (HCV RNA) was repeated at 3 months, end of treatment (EOT) and 6 months after EOT for patients HCV RNA negative at EOT. Liver biopsies were performed prior to treatment and at EOT. Results: Thirty nine patients were eligible. Twenty two completed treatment and 17 (43.6%) were intolerant. Eleven of 22 (50%) patients who completed treatment developed sustained viral response (SVR). Two patients intolerant to treatment also developed SVR. Serial biopsies were performed in 17 patients and refused in five. Improved fibrosis scores were present in four patients (non-responders, n=2), unchanged in 10 (non-responders, n=4), and worse in three (all non-responders). Conclusions: Side effects are an important limiting factor in recurrent HCV treatment with SVR only 33.3% in an intention-to-treat analysis. However, improved or stable fibrosis scores were also demonstrated in 66.7% of non-responders. This suggests failure to eradicate HCV should not necessarily lead to treatment discontinuation as a subgroup of patients may benefit from maintenance therapy.

Original languageEnglish
Pages (from-to)529-535
Number of pages7
JournalLiver International
Volume26
Issue number5
DOIs
StatePublished - Jun 2006
Externally publishedYes

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Ribavirin
Hepatitis C
Liver Cirrhosis
Interferons
Transplants
Liver
Hepacivirus
Therapeutics
Fibrosis
RNA
Biopsy
Intention to Treat Analysis

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

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title = "Impact of pegylated interferon α-2B and ribavirin on hepatic fibrosis in liver transplant patients with recurrent hepatitis C: An open-label series",
abstract = "Background: Patients with recurrent hepatitis C virus (HCV) are often treated with interferon-based therapy in an attempt to eradicate HCV and prevent cirrhosis requiring retransplantation. We describe our experience with pegylated interferon and ribavirin and the impact of this therapy on hepatic fibrosis. Methods: Patients were treated with pegylated interferon α-2b 1.5mcg/kg/week and ribavirin 800mg/day for 6-12 months according to genotype. HCV ribonucleic acid (HCV RNA) was repeated at 3 months, end of treatment (EOT) and 6 months after EOT for patients HCV RNA negative at EOT. Liver biopsies were performed prior to treatment and at EOT. Results: Thirty nine patients were eligible. Twenty two completed treatment and 17 (43.6{\%}) were intolerant. Eleven of 22 (50{\%}) patients who completed treatment developed sustained viral response (SVR). Two patients intolerant to treatment also developed SVR. Serial biopsies were performed in 17 patients and refused in five. Improved fibrosis scores were present in four patients (non-responders, n=2), unchanged in 10 (non-responders, n=4), and worse in three (all non-responders). Conclusions: Side effects are an important limiting factor in recurrent HCV treatment with SVR only 33.3{\%} in an intention-to-treat analysis. However, improved or stable fibrosis scores were also demonstrated in 66.7{\%} of non-responders. This suggests failure to eradicate HCV should not necessarily lead to treatment discontinuation as a subgroup of patients may benefit from maintenance therapy.",
author = "Sandeep Mukherjee and Elizabeth Lyden",
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T1 - Impact of pegylated interferon α-2B and ribavirin on hepatic fibrosis in liver transplant patients with recurrent hepatitis C

T2 - An open-label series

AU - Mukherjee, Sandeep

AU - Lyden, Elizabeth

PY - 2006/6

Y1 - 2006/6

N2 - Background: Patients with recurrent hepatitis C virus (HCV) are often treated with interferon-based therapy in an attempt to eradicate HCV and prevent cirrhosis requiring retransplantation. We describe our experience with pegylated interferon and ribavirin and the impact of this therapy on hepatic fibrosis. Methods: Patients were treated with pegylated interferon α-2b 1.5mcg/kg/week and ribavirin 800mg/day for 6-12 months according to genotype. HCV ribonucleic acid (HCV RNA) was repeated at 3 months, end of treatment (EOT) and 6 months after EOT for patients HCV RNA negative at EOT. Liver biopsies were performed prior to treatment and at EOT. Results: Thirty nine patients were eligible. Twenty two completed treatment and 17 (43.6%) were intolerant. Eleven of 22 (50%) patients who completed treatment developed sustained viral response (SVR). Two patients intolerant to treatment also developed SVR. Serial biopsies were performed in 17 patients and refused in five. Improved fibrosis scores were present in four patients (non-responders, n=2), unchanged in 10 (non-responders, n=4), and worse in three (all non-responders). Conclusions: Side effects are an important limiting factor in recurrent HCV treatment with SVR only 33.3% in an intention-to-treat analysis. However, improved or stable fibrosis scores were also demonstrated in 66.7% of non-responders. This suggests failure to eradicate HCV should not necessarily lead to treatment discontinuation as a subgroup of patients may benefit from maintenance therapy.

AB - Background: Patients with recurrent hepatitis C virus (HCV) are often treated with interferon-based therapy in an attempt to eradicate HCV and prevent cirrhosis requiring retransplantation. We describe our experience with pegylated interferon and ribavirin and the impact of this therapy on hepatic fibrosis. Methods: Patients were treated with pegylated interferon α-2b 1.5mcg/kg/week and ribavirin 800mg/day for 6-12 months according to genotype. HCV ribonucleic acid (HCV RNA) was repeated at 3 months, end of treatment (EOT) and 6 months after EOT for patients HCV RNA negative at EOT. Liver biopsies were performed prior to treatment and at EOT. Results: Thirty nine patients were eligible. Twenty two completed treatment and 17 (43.6%) were intolerant. Eleven of 22 (50%) patients who completed treatment developed sustained viral response (SVR). Two patients intolerant to treatment also developed SVR. Serial biopsies were performed in 17 patients and refused in five. Improved fibrosis scores were present in four patients (non-responders, n=2), unchanged in 10 (non-responders, n=4), and worse in three (all non-responders). Conclusions: Side effects are an important limiting factor in recurrent HCV treatment with SVR only 33.3% in an intention-to-treat analysis. However, improved or stable fibrosis scores were also demonstrated in 66.7% of non-responders. This suggests failure to eradicate HCV should not necessarily lead to treatment discontinuation as a subgroup of patients may benefit from maintenance therapy.

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