Antiviral therapy and fibrosis progression in patients with mild-moderate hepatitis C recurrence after liver transplantation. A randomized controlled study

Luca S. Belli, Riccardo Volpes, Ivo Graziadei, Stefano Fagiuoli, Peter Starkel, Patrizia Burra, Alberto B. Alberti, Bruno Gridelli, Wolfgang Vogel, Luisa Pasulo, Eleonora De Martin, Maria Guido, Luciano De Carlis, Jan Lerut, Umberto Cillo, Andrew K. Burroughs, Giovambattista Pinzello

Research output: Contribution to journalArticle

Abstract

Backgrounds/aims: We evaluated the effect of antiviral therapy on fibrosis progression in patients with histological features of mild/moderate HCV disease recurrence defined by a Grading score. ≥. 4 and Staging score up to 3 (Ishak) at 1 year after liver transplantation. Methods: Seventy-three consecutive patients with mild/moderate recurrence were randomized either to no treatment or to receive Pegilated-Interferon-alfa-2b and ribavirin for 52 weeks. Liver biopsies obtained at baseline (1 year after transplantation) and 2 years afterwards were evaluated for assessment of disease progression, defined as worsening of at least 2 staging points or progression to stage 4 or higher. Results: As for these two major histological end points there were no statistically significant differences between the 2 groups (36.1% vs. 50%, . p=. 0.34 and 36.1% vs. 38.9%, . p=. 1). Fifteen treated patients (41%) achieved a sustained virological response which was associated with a reduced risk of fibrosis worsening for both endpoints when compared to viremic patients (. p=. 0.04). Conclusions: Although antiviral-therapy was beneficial in preventing fibrosis progression in patients achieving a sustained virological response, the majority of the overall population of our patients with mild-moderate disease recurrence could not benefit from antiviral therapy either because they either could not be treated or did not respond to treatment (EudraCT number: 2005-005760).

Original languageEnglish
Pages (from-to)603-609
Number of pages7
JournalDigestive and Liver Disease
Volume44
Issue number7
DOIs
Publication statusPublished - Jul 2012

Keywords

  • HCV
  • PEG-Interferon
  • Recurrent hepatitis
  • Ribavirin

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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    Belli, L. S., Volpes, R., Graziadei, I., Fagiuoli, S., Starkel, P., Burra, P., Alberti, A. B., Gridelli, B., Vogel, W., Pasulo, L., De Martin, E., Guido, M., De Carlis, L., Lerut, J., Cillo, U., Burroughs, A. K., & Pinzello, G. (2012). Antiviral therapy and fibrosis progression in patients with mild-moderate hepatitis C recurrence after liver transplantation. A randomized controlled study. Digestive and Liver Disease, 44(7), 603-609. https://doi.org/10.1016/j.dld.2012.01.017