Hepatitis C virus recurrence after liver transplantation: A 10-year evaluation

Stefano Gitto, Luca Saverio Belli, Ranka Vukotic, Stefania Lorenzini, Aldo Airoldi, Arrigo Francesco Giuseppe Cicero, Marcello Vangeli, Lucia Brodosi, Arianna Martello Panno, Roberto Di Donato, Matteo Cescon, Gian Luca Grazi, Luciano De Carlis, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreone

Research output: Contribution to journalArticle

Abstract

AIM: To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. /// METHODS: Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ 2, Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A p level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic regression./// RESULTS: The ten-year survival of the entire popu lation was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status (mild hepatitis C recurrence, "too sick to be treated" and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different (59.1% vs 64.7%, p = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the "non-responders" (84.7% vs 39.8%, p <0.0001) and too sick to be treated (84.7% vs 0%, p <0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence (84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival./// CONCLUSION: Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence.

Original languageEnglish
Pages (from-to)3912-3920
Number of pages9
JournalWorld Journal of Gastroenterology
Volume21
Issue number13
DOIs
Publication statusPublished - Apr 7 2015

Keywords

  • Antiviral treatment
  • Hepatitis C
  • Hepatitis C virus recurrence
  • Liver transplantation
  • Ten-year survival

ASJC Scopus subject areas

  • Gastroenterology

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  • Cite this

    Gitto, S., Belli, L. S., Vukotic, R., Lorenzini, S., Airoldi, A., Cicero, A. F. G., Vangeli, M., Brodosi, L., Panno, A. M., Di Donato, R., Cescon, M., Grazi, G. L., De Carlis, L., Pinna, A. D., Bernardi, M., & Andreone, P. (2015). Hepatitis C virus recurrence after liver transplantation: A 10-year evaluation. World Journal of Gastroenterology, 21(13), 3912-3920. https://doi.org/10.3748/wjg.v21.i13.3912