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Predictive Factors of Lack of Response to Antiviral Therapy Among in Patients With Recurrent Hepatitis C After Liver Transplantation
Authors:M. Marino  R.M. Iemmolo  M. Bertolotti  N. De Ruvo  G. Guerrini  G.E. Gerunda
Affiliation:a Chirurgia Trapianti di Fegato e Multiviscerale, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
b Dipartimento di Medicina, Endocrinologia Metabolismo e Geriatria, Università di Modena e Reggio Emilia, Modena, Italy
Abstract:The current therapy for hepatitis C recurrence after liver transplantation OLT is based on interferon (IFN) and ribavirin (RBV) in monotherapy or combination. The rate of sustained virological response (SVR) varies between 10% and 45%. We have retrospectively analyzed factors that could predict SVR after antiviral therapy. We analyzed 42 patients who completed a cycle of therapy with natural or pegylated IFN plus RBV. There were 15 (35.7%) patients who obtained an SVR. The following factors were significantly associated with a lack of SVR: donor age ≥50 years (P = .046); donor body mass index (BMI) > 27 (P = .016); genotype 1 versus 2 to 3 (P = 0.010), aspartate transferase (AST) before therapy ≥ 140 U/L (P = .046), alanine transferase before therapy ≥ 280 U/L (P = .055), use of natural IFN versus pegylated IFN (P = .016). The only factors remaining after multivariate analysis were: donor BMI, AST before therapy and genotype. Our data confirmed that genotype 1 was associated with poorer outcomes; other additional parameters can influence the response to antiviral therapy.
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