Transplantation proceedings · 2009
The benefits of interferon treatment in patients without sustained viral response after living donor liver transplantation for hepatitis C.
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Ikegami T, Taketomi A, Soejima Y, Yoshizumi T, Fukuhara T, Kotoh K, Shimoda S, Kato M, Maehara Y
Аннотация
UNLABELLED: Although it has been recognized that interferon (IFN) treatment is crucial for recurrent hepatitis C after liver transplantation, its benefits have not been determined among patients without a sustained viral response (SVR).
METHODS: Eighty patients who received IFN plus ribavirin treatment after living donor liver transplantation were grouped as follows: group I (n = 18) SVR; group II (n = 25) no-SVR but viral response [VR] positive; Group III (n = 13) no-VR but biochemical response [BR] positive; and group IV (n = 24) no-VR and no-BR.
RESULTS: In groups II and III, not only the histological activity grade and fibrosis stage, but also the serum parameters including transaminases and type IV collagen were stable for 3 years after induction of IFN-based treatment. In group I, the activity grade and fibrosis stage significantly improved (P < .01). In group IV, the fibrosis stage significantly deteriorated (P < .01); the serum transaminases and type IV collagen were significantly higher than the other groups (P < .01). The mean duration of IFN treatment was significantly longer among group II (96 weeks) compared with the other cohorts (P < .05). The 5-year graft survival rate in groups II (91%) and III (100%) were comparable to those of group I (100%); group IV (62%) was significantly lower than the other groups (P < .05).
CONCLUSION: IFN treatment was beneficial even among subjects with IFN-dependent VR or BR, although they did not achieve SVR.
METHODS: Eighty patients who received IFN plus ribavirin treatment after living donor liver transplantation were grouped as follows: group I (n = 18) SVR; group II (n = 25) no-SVR but viral response [VR] positive; Group III (n = 13) no-VR but biochemical response [BR] positive; and group IV (n = 24) no-VR and no-BR.
RESULTS: In groups II and III, not only the histological activity grade and fibrosis stage, but also the serum parameters including transaminases and type IV collagen were stable for 3 years after induction of IFN-based treatment. In group I, the activity grade and fibrosis stage significantly improved (P < .01). In group IV, the fibrosis stage significantly deteriorated (P < .01); the serum transaminases and type IV collagen were significantly higher than the other groups (P < .01). The mean duration of IFN treatment was significantly longer among group II (96 weeks) compared with the other cohorts (P < .05). The 5-year graft survival rate in groups II (91%) and III (100%) were comparable to those of group I (100%); group IV (62%) was significantly lower than the other groups (P < .05).
CONCLUSION: IFN treatment was beneficial even among subjects with IFN-dependent VR or BR, although they did not achieve SVR.
Предметные рубрики MeSH
AgedAlanine TransaminaseAntiviral AgentsAspartate AminotransferasesFemaleGenotypeGraft SurvivalHepatitis C, ChronicHumansInterferon alpha-2Interferon-alphaLiver TransplantationLiving DonorsMaleMiddle AgedPolymerase Chain ReactionRNA, ViralRecombinant ProteinsRecurrenceRetrospective StudiesRibavirinSurvival Rate