A randomized study on Peg-interferon alfa-2a with or without ribavirin in liver transplant recipients with recurrent hepatitis C

Mario Angelico, Alessandra Petrolati, Raffaella Lionetti, Ilaria Lenci, Patrizia Burra, Maria Francesca Donato, Manuela Merli, Mario Strazzabosco, Giuseppe Tisone

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Abstract

Background/Aims: We performed a randomized trial on pegylated interferon alfa-2a (Peg-IFNα) monotherapy vs Peg-IFNα and ribavirin in non-cirrhotic liver transplant recipients with recurrent hepatitis C. Methods: Forty-two patients transplanted for HCV-related cirrhosis 12-96 months earlier were randomized to Peg-IFNα monotherapy (180 μg weekly) or Peg-IFNα and ribavirin, up to the maximum tolerated dose, for 48 weeks. Results: Early virological response (EVR, i.e., HCV-RNA ≥ 2 log drop at week 12) occurred in 76% of the monotherapy and 71% of the combination groups, respectively (intention-to treat). Sustained virological response (SVR) occurred in 8 (38%) and 7 (33%) patients, respectively. EVR had a positive predictive value for SVR of 50% and 47%, respectively, and a 100% negative predictive value in both groups. Six drop-outs occurred in the monotherapy (including 3 rejections) and 7 in the combination groups (including one rejection). Peg-INFα dose was reduced in 7 and 8 patients, respectively. The average daily dose of ribavirin was 435 mg/day. Conclusions: Peg-IFNα-2a, with or without ribavirin, induces SVR in one-third of transplant recipients with recurrent hepatitis C. Treatment cessation is indicated in patients without EVR. The low SVR rate is mainly due to inability to sustain full doses of antivirals and lack of the booster effect of ribavirin.

Original languageEnglish
Pages (from-to)1009-1017
Number of pages9
JournalJournal of Hepatology
Volume46
Issue number6
DOIs
Publication statusPublished - Jun 2007

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Keywords

  • HCV
  • Liver transplantation
  • Peginterferon alfa-2a
  • Ribavirin
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

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