Impact of pegylated interferon alfa-2a 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

17 Citations (Scopus)

Abstract

Background/Aims: Patients with recurrent hepatitis C are often treated with interferon-based therapy in an attempt to prevent cirrhosis requiring retransplantation. We describe our experience with 32 patients with recurrent HCV. Methodology: Patients were followed prospectively after starting pegylated interferon alfa-2a 180μg per week and ribavfrin 1000-1200mg per day. HCV ribonucleic acid (HCVRNA) was repeated at three months, end of treatment (EOT) and six months after EOT for patients HCVRNA negative at EOT. Results: There were 22 males and 10 females. 21 patients have completed treatment, six remain on therapy and five were intolerant. In an intention-to-treat analysis, sustained viral eradication occurred in 40.6% of patients. Fibrosis scores were worse in eight patients of whom six were sustained responders. Three of these patients developed decompensated liver disease. Two were successfully retransplanted and remain HCVRNA negative after a mean follow-up of 11 months. Conclusions: Pegylated interferon alpha-2a and ribavirin were well tolerated in this small series. Sustained HCV eradication occurred in at least 40.6% of patients but progressive fibrosis occurred in 75% of sustained responders. This suggests that mechanisms other than recurrent HCV may be responsible for cirrhosis in sustained responders who remain at risk of developing decompensated liver disease.

Original languageEnglish
Pages (from-to)561-565
Number of pages5
JournalHepato-Gastroenterology
Volume53
Issue number70
StatePublished - Jul 2006
Externally publishedYes

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Ribavirin
Hepatitis C
Liver Cirrhosis
Transplants
Liver
Fibrosis
RNA
Liver Diseases
Therapeutics
peginterferon alfa-2a
Intention to Treat Analysis
Interferons

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

@article{14be875c72db460bb27417efd5ba31fc,
title = "Impact of pegylated interferon alfa-2a and ribavirin on hepatic fibrosis in liver transplant patients with recurrent hepatitis C: An open-label series",
abstract = "Background/Aims: Patients with recurrent hepatitis C are often treated with interferon-based therapy in an attempt to prevent cirrhosis requiring retransplantation. We describe our experience with 32 patients with recurrent HCV. Methodology: Patients were followed prospectively after starting pegylated interferon alfa-2a 180μg per week and ribavfrin 1000-1200mg per day. HCV ribonucleic acid (HCVRNA) was repeated at three months, end of treatment (EOT) and six months after EOT for patients HCVRNA negative at EOT. Results: There were 22 males and 10 females. 21 patients have completed treatment, six remain on therapy and five were intolerant. In an intention-to-treat analysis, sustained viral eradication occurred in 40.6{\%} of patients. Fibrosis scores were worse in eight patients of whom six were sustained responders. Three of these patients developed decompensated liver disease. Two were successfully retransplanted and remain HCVRNA negative after a mean follow-up of 11 months. Conclusions: Pegylated interferon alpha-2a and ribavirin were well tolerated in this small series. Sustained HCV eradication occurred in at least 40.6{\%} of patients but progressive fibrosis occurred in 75{\%} of sustained responders. This suggests that mechanisms other than recurrent HCV may be responsible for cirrhosis in sustained responders who remain at risk of developing decompensated liver disease.",
author = "Sandeep Mukherjee and Elizabeth Lyden",
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language = "English",
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T2 - An open-label series

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AU - Lyden, Elizabeth

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N2 - Background/Aims: Patients with recurrent hepatitis C are often treated with interferon-based therapy in an attempt to prevent cirrhosis requiring retransplantation. We describe our experience with 32 patients with recurrent HCV. Methodology: Patients were followed prospectively after starting pegylated interferon alfa-2a 180μg per week and ribavfrin 1000-1200mg per day. HCV ribonucleic acid (HCVRNA) was repeated at three months, end of treatment (EOT) and six months after EOT for patients HCVRNA negative at EOT. Results: There were 22 males and 10 females. 21 patients have completed treatment, six remain on therapy and five were intolerant. In an intention-to-treat analysis, sustained viral eradication occurred in 40.6% of patients. Fibrosis scores were worse in eight patients of whom six were sustained responders. Three of these patients developed decompensated liver disease. Two were successfully retransplanted and remain HCVRNA negative after a mean follow-up of 11 months. Conclusions: Pegylated interferon alpha-2a and ribavirin were well tolerated in this small series. Sustained HCV eradication occurred in at least 40.6% of patients but progressive fibrosis occurred in 75% of sustained responders. This suggests that mechanisms other than recurrent HCV may be responsible for cirrhosis in sustained responders who remain at risk of developing decompensated liver disease.

AB - Background/Aims: Patients with recurrent hepatitis C are often treated with interferon-based therapy in an attempt to prevent cirrhosis requiring retransplantation. We describe our experience with 32 patients with recurrent HCV. Methodology: Patients were followed prospectively after starting pegylated interferon alfa-2a 180μg per week and ribavfrin 1000-1200mg per day. HCV ribonucleic acid (HCVRNA) was repeated at three months, end of treatment (EOT) and six months after EOT for patients HCVRNA negative at EOT. Results: There were 22 males and 10 females. 21 patients have completed treatment, six remain on therapy and five were intolerant. In an intention-to-treat analysis, sustained viral eradication occurred in 40.6% of patients. Fibrosis scores were worse in eight patients of whom six were sustained responders. Three of these patients developed decompensated liver disease. Two were successfully retransplanted and remain HCVRNA negative after a mean follow-up of 11 months. Conclusions: Pegylated interferon alpha-2a and ribavirin were well tolerated in this small series. Sustained HCV eradication occurred in at least 40.6% of patients but progressive fibrosis occurred in 75% of sustained responders. This suggests that mechanisms other than recurrent HCV may be responsible for cirrhosis in sustained responders who remain at risk of developing decompensated liver disease.

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