Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression

Raffaella Lionetti, Giuseppe Tisone, Giampiero Palmieri, Cristiana Almerighi, Alessandra Anselmo, Laura Tariciotti, Ilaria Lenci, Linda De Luca, Andrea Monaco, Mario Angelico

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Fibrosis in liver transplant recipients with recurrent HCV is fast, yet, different patterns of progression are recognized. Aims: To investigate histological findings associated with maintenance ribavirin monotherapy in patients with recurrent HCV transplanted ≥4 years earlier. Methods: 14 recipients at high risk of progression (fibrosis progression rate >0.33 units/year and/or persistently elevated ALT) were assigned to receive ribavirin for 3 years. 11 patients at lower risk of progression (FPR ≤0.33 units/year and normal ALT) as controls. Biopsies were obtained yearly since transplant and 7 consecutive biopsies were evaluated. Results: Improved necroinflammation (reduction ≥2 grading) was observed in 7 treated with ribavirin and 3 untreated patients, while 1 and 3 patients worsened respectively. Fibrosis improved (reduction >1 staging) in 2 ribavirin-treated patients, unchanged in 10 and worsened (increase ≥1 staging) in 2. Fibrosis progression decreased from 0.48 ± 0.27 observed during the 3-year pre-treatment period to 0.04 ± 0.31 units/year (p = 0.003) during the 3 years of ribavirin. Among untreated fibrosis remained unchanged in 1 and worsened in 10 (p <0.001), yearly fibrosis progression rate increasing from 0.15 ± 0.17 units/year to 0.42 ± 0.39 units/year (p = 0.10). Conclusions: Maintenance ribavirin monotherapy delays fibrosis progression in high risk patients, offering an alternative strategy for those failing to respond to conventional treatment.

Original languageEnglish
Pages (from-to)297-303
Number of pages7
JournalDigestive and Liver Disease
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 2010

Fingerprint

Ribavirin
Hepatitis C
Fibrosis
Maintenance
Liver
Biopsy
Liver Cirrhosis
Transplant Recipients
Transplants
Therapeutics

Keywords

  • Disease recurrence
  • Grading
  • Graft
  • Immunosuppression
  • Staging

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression. / Lionetti, Raffaella; Tisone, Giuseppe; Palmieri, Giampiero; Almerighi, Cristiana; Anselmo, Alessandra; Tariciotti, Laura; Lenci, Ilaria; De Luca, Linda; Monaco, Andrea; Angelico, Mario.

In: Digestive and Liver Disease, Vol. 42, No. 4, 04.2010, p. 297-303.

Research output: Contribution to journalArticle

Lionetti, R, Tisone, G, Palmieri, G, Almerighi, C, Anselmo, A, Tariciotti, L, Lenci, I, De Luca, L, Monaco, A & Angelico, M 2010, 'Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression', Digestive and Liver Disease, vol. 42, no. 4, pp. 297-303. https://doi.org/10.1016/j.dld.2009.08.008
Lionetti, Raffaella ; Tisone, Giuseppe ; Palmieri, Giampiero ; Almerighi, Cristiana ; Anselmo, Alessandra ; Tariciotti, Laura ; Lenci, Ilaria ; De Luca, Linda ; Monaco, Andrea ; Angelico, Mario. / Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression. In: Digestive and Liver Disease. 2010 ; Vol. 42, No. 4. pp. 297-303.
@article{ab5fe8258296479997771e511108bb0f,
title = "Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression",
abstract = "Background: Fibrosis in liver transplant recipients with recurrent HCV is fast, yet, different patterns of progression are recognized. Aims: To investigate histological findings associated with maintenance ribavirin monotherapy in patients with recurrent HCV transplanted ≥4 years earlier. Methods: 14 recipients at high risk of progression (fibrosis progression rate >0.33 units/year and/or persistently elevated ALT) were assigned to receive ribavirin for 3 years. 11 patients at lower risk of progression (FPR ≤0.33 units/year and normal ALT) as controls. Biopsies were obtained yearly since transplant and 7 consecutive biopsies were evaluated. Results: Improved necroinflammation (reduction ≥2 grading) was observed in 7 treated with ribavirin and 3 untreated patients, while 1 and 3 patients worsened respectively. Fibrosis improved (reduction >1 staging) in 2 ribavirin-treated patients, unchanged in 10 and worsened (increase ≥1 staging) in 2. Fibrosis progression decreased from 0.48 ± 0.27 observed during the 3-year pre-treatment period to 0.04 ± 0.31 units/year (p = 0.003) during the 3 years of ribavirin. Among untreated fibrosis remained unchanged in 1 and worsened in 10 (p <0.001), yearly fibrosis progression rate increasing from 0.15 ± 0.17 units/year to 0.42 ± 0.39 units/year (p = 0.10). Conclusions: Maintenance ribavirin monotherapy delays fibrosis progression in high risk patients, offering an alternative strategy for those failing to respond to conventional treatment.",
keywords = "Disease recurrence, Grading, Graft, Immunosuppression, Staging",
author = "Raffaella Lionetti and Giuseppe Tisone and Giampiero Palmieri and Cristiana Almerighi and Alessandra Anselmo and Laura Tariciotti and Ilaria Lenci and {De Luca}, Linda and Andrea Monaco and Mario Angelico",
year = "2010",
month = "4",
doi = "10.1016/j.dld.2009.08.008",
language = "English",
volume = "42",
pages = "297--303",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier B.V.",
number = "4",

}

TY - JOUR

T1 - Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression

AU - Lionetti, Raffaella

AU - Tisone, Giuseppe

AU - Palmieri, Giampiero

AU - Almerighi, Cristiana

AU - Anselmo, Alessandra

AU - Tariciotti, Laura

AU - Lenci, Ilaria

AU - De Luca, Linda

AU - Monaco, Andrea

AU - Angelico, Mario

PY - 2010/4

Y1 - 2010/4

N2 - Background: Fibrosis in liver transplant recipients with recurrent HCV is fast, yet, different patterns of progression are recognized. Aims: To investigate histological findings associated with maintenance ribavirin monotherapy in patients with recurrent HCV transplanted ≥4 years earlier. Methods: 14 recipients at high risk of progression (fibrosis progression rate >0.33 units/year and/or persistently elevated ALT) were assigned to receive ribavirin for 3 years. 11 patients at lower risk of progression (FPR ≤0.33 units/year and normal ALT) as controls. Biopsies were obtained yearly since transplant and 7 consecutive biopsies were evaluated. Results: Improved necroinflammation (reduction ≥2 grading) was observed in 7 treated with ribavirin and 3 untreated patients, while 1 and 3 patients worsened respectively. Fibrosis improved (reduction >1 staging) in 2 ribavirin-treated patients, unchanged in 10 and worsened (increase ≥1 staging) in 2. Fibrosis progression decreased from 0.48 ± 0.27 observed during the 3-year pre-treatment period to 0.04 ± 0.31 units/year (p = 0.003) during the 3 years of ribavirin. Among untreated fibrosis remained unchanged in 1 and worsened in 10 (p <0.001), yearly fibrosis progression rate increasing from 0.15 ± 0.17 units/year to 0.42 ± 0.39 units/year (p = 0.10). Conclusions: Maintenance ribavirin monotherapy delays fibrosis progression in high risk patients, offering an alternative strategy for those failing to respond to conventional treatment.

AB - Background: Fibrosis in liver transplant recipients with recurrent HCV is fast, yet, different patterns of progression are recognized. Aims: To investigate histological findings associated with maintenance ribavirin monotherapy in patients with recurrent HCV transplanted ≥4 years earlier. Methods: 14 recipients at high risk of progression (fibrosis progression rate >0.33 units/year and/or persistently elevated ALT) were assigned to receive ribavirin for 3 years. 11 patients at lower risk of progression (FPR ≤0.33 units/year and normal ALT) as controls. Biopsies were obtained yearly since transplant and 7 consecutive biopsies were evaluated. Results: Improved necroinflammation (reduction ≥2 grading) was observed in 7 treated with ribavirin and 3 untreated patients, while 1 and 3 patients worsened respectively. Fibrosis improved (reduction >1 staging) in 2 ribavirin-treated patients, unchanged in 10 and worsened (increase ≥1 staging) in 2. Fibrosis progression decreased from 0.48 ± 0.27 observed during the 3-year pre-treatment period to 0.04 ± 0.31 units/year (p = 0.003) during the 3 years of ribavirin. Among untreated fibrosis remained unchanged in 1 and worsened in 10 (p <0.001), yearly fibrosis progression rate increasing from 0.15 ± 0.17 units/year to 0.42 ± 0.39 units/year (p = 0.10). Conclusions: Maintenance ribavirin monotherapy delays fibrosis progression in high risk patients, offering an alternative strategy for those failing to respond to conventional treatment.

KW - Disease recurrence

KW - Grading

KW - Graft

KW - Immunosuppression

KW - Staging

UR - http://www.scopus.com/inward/record.url?scp=77649191026&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77649191026&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2009.08.008

DO - 10.1016/j.dld.2009.08.008

M3 - Article

VL - 42

SP - 297

EP - 303

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 4

ER -