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Antiviral re‐treatment of IFN‐Ribavirin non‐responders for recurrent post‐transplantation hepatitis C
Authors:Süleyman Yedibela  Resit Demir  Nathaniel Melling  Ünal Aydin  Detlef Schuppan  Volker Müller  Werner Hohenberger  Frank Schnleben
Abstract:Yedibela S, Demir R, Melling N, Aydin Ü, Schuppan D, Müller V, Hohenberger W, Schönleben F. Antiviral re‐treatment of IFN‐Ribavirin non‐responders for recurrent post‐transplantation hepatitis C.
Clin Transplant 2011: 25: 131–135. © 2010 John Wiley & Sons A/S. Abstract: Background: The aim of the study was to compare the efficacy and tolerability of pegylated interferon (PEG‐IFN) plus ribavirin (RIB) and PEG‐IFN monotherapy after unsuccessful initial therapy with interferon‐α2b (IFN) plus RIB after recurrent post‐transplantation hepatitis C. Methods: Twenty‐four patients with either no response (n = 10) or relapse (n = 14) after treatment with IFN plus RIB were prospectively randomized in the two treatment arms: 1) PEG‐IFN monotherapy at a dosage of 0.8 μg/kg per week (n = 12) and 2) PEG‐IFN (0.8 μg/kg per week) plus RIB (800–1200 mg/d) (n = 12). Results: Twenty‐one patients (86%) were treated for at least six months. Three patients are still being treated. At the end of therapy, 18 patients (75%) were HCV RNA negative. Five (45%) patients in PEG‐IFN and five (50%) in PEG‐IFN plus RIB arms had sustained virological response. Two patients (10%) died from recurrent hepatocellular carcinoma. The histologic activity indices significantly improved in both treatment arms. In the PEG‐IFN arm, one patient experienced an acute rejection and discontinued therapy. Conclusions: Both treatment arms showed to be effective, well tolerated and lead to an improvement in histologic outcome. Because of lower rates in side effects and equal outcome, PEG‐IFN monotherapy is an adequate option for antiviral re‐treatment.
Keywords:hepatitis C recurrence  liver transplantation  non‐responder  pegylated interferon  relapser
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