Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent hepatitis C after liver transplantation

Sandeep Mukherjee, J. Rogge, L. Weaver, D. F. Schafer

Research output: Contribution to journalArticle

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Abstract

Recurrent hepatitis C is often treated with an interferon and ribavirin combination therapy, but the results have been disappointing. Given the promising results reported with pegylated interferon and ribavirin for hepatitis C, we were interested in evaluating the effectiveness of this treatment in liver transplant recipients with recurrent hepatitis C (HCV). Methods. Between November 2001 and September 2002, patients with recurrent HCV were screened to determine if they were eligible for treatment. Liver function tests, HCV-RNA, and liver biopsies were performed on all patients prior to treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and 6 months after EOT for patients who were HCV-RNA negative at EOT. Patients were prospectively followed after starting weekly pegylated interferon alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough, Kenilworth, NJ, USA) with folic acid 1 mg per day. Results. Thirty-nine patients eligible for treatment displayed a median age of 50.4 years. Eighteen patients completed treatment, 4 remain on treatment, and 17 were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients who completed treatment. Side effects led to treatment withdrawal in 17 patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA eradication occurred in 30.8% of patients. Conclusion. Side effects are an important limiting factor in the treatment of recurrent HCV with pegylated interferon and ribavirin. However, these results are encouraging as sustained HCV eradication occurred in at least 66.7% of patients who completed treatment. Prospective randomized trials are required to assess the effectiveness of this treatment and its impact on quality of life and histology.

Original languageEnglish
Pages (from-to)3042-3044
Number of pages3
JournalTransplantation Proceedings
Volume35
Issue number8
DOIs
StatePublished - Dec 2003
Externally publishedYes

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Ribavirin
Hepatitis C
Liver Transplantation
RNA
Therapeutics
Interferons
peginterferon alfa-2b
Intention to Treat Analysis
Liver
Liver Function Tests
Folic Acid
Histology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent hepatitis C after liver transplantation. / Mukherjee, Sandeep; Rogge, J.; Weaver, L.; Schafer, D. F.

In: Transplantation Proceedings, Vol. 35, No. 8, 12.2003, p. 3042-3044.

Research output: Contribution to journalArticle

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abstract = "Recurrent hepatitis C is often treated with an interferon and ribavirin combination therapy, but the results have been disappointing. Given the promising results reported with pegylated interferon and ribavirin for hepatitis C, we were interested in evaluating the effectiveness of this treatment in liver transplant recipients with recurrent hepatitis C (HCV). Methods. Between November 2001 and September 2002, patients with recurrent HCV were screened to determine if they were eligible for treatment. Liver function tests, HCV-RNA, and liver biopsies were performed on all patients prior to treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and 6 months after EOT for patients who were HCV-RNA negative at EOT. Patients were prospectively followed after starting weekly pegylated interferon alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough, Kenilworth, NJ, USA) with folic acid 1 mg per day. Results. Thirty-nine patients eligible for treatment displayed a median age of 50.4 years. Eighteen patients completed treatment, 4 remain on treatment, and 17 were intolerant. Sustained HCV-RNA eradication occurred in 66.7{\%} of patients who completed treatment. Side effects led to treatment withdrawal in 17 patients (43.6{\%}) In an intention-to treat analysis, sustained HCV-RNA eradication occurred in 30.8{\%} of patients. Conclusion. Side effects are an important limiting factor in the treatment of recurrent HCV with pegylated interferon and ribavirin. However, these results are encouraging as sustained HCV eradication occurred in at least 66.7{\%} of patients who completed treatment. Prospective randomized trials are required to assess the effectiveness of this treatment and its impact on quality of life and histology.",
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