Treatment of genotype-1 hepatitis C recurrence after liver transplant improves survival in both sustained responders and relapsers

Francesca Romana Ponziani, Alessandro Milani, Antonio Gasbarrini, Raffaella Zaccaria, Raffaella Viganò, Rosa Maria Iemmolo, Maria Francesca Donato, Maria Rendina, Pierluigi Toniutto, Luisa Pasulo, Matteo Cescon, Patrizia Burra, Lucia Miglioresi, Manuela Merli, Daniele Di Paolo, Stefano Fagiuoli, Maurizio Pompili

Research output: Contribution to journalArticle

Abstract

The aim of this study was to evaluate the factors affecting the response to treatment and how it could affect survival in a large series of genotype-1 HCV-transplanted patients. Three-hundred and twenty six genotype-1 HCV patients were enrolled. One hundred and ninety-six patients (60.1%) were nonresponders and 130 (39.9%) showed negative HCV-RNA at the end of treatment. Eighty-four of them (25.8%) achieved sustained virological response, while 46 (14.1%) showed viral relapse. Five-year cumulative survival was significantly worse in nonresponders (76.4%) compared with sustained viral response (93.2) or relapsers (94.9%). Sustained responders and relapsers were therefore considered as a single 'response group' in further analysis. Pretreatment variables significantly associated with virological response at multivariate regression analysis were the absence of ineffective pretransplant antiviral therapy, the recurrence of HCV-hepatitis more than 1 year after transplant, an histological grading ≥4 at pretreatment liver biopsy, a pretreatment HCV-RNA level 6IU/ml, and the absence of diabetes. As expected, also on-treatment variables (rapid and early virological response) were significantly associated to the response to antiviral treatment. In conclusion, this study shows that postliver transplant antiviral treatment results in beneficial effect on survival not only in sustained responders but also in relapsers.

Original languageEnglish
Pages (from-to)281-289
Number of pages9
JournalTransplant International
Volume26
Issue number3
DOIs
Publication statusPublished - Mar 2013

Keywords

  • antiviral treatment
  • genotype-1
  • hepatitis C recurrence
  • hepatitis C virus
  • liver transplant
  • pegylated interferon
  • responders
  • ribavirin
  • survival

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Ponziani, F. R., Milani, A., Gasbarrini, A., Zaccaria, R., Viganò, R., Iemmolo, R. M., Donato, M. F., Rendina, M., Toniutto, P., Pasulo, L., Cescon, M., Burra, P., Miglioresi, L., Merli, M., Paolo, D. D., Fagiuoli, S., & Pompili, M. (2013). Treatment of genotype-1 hepatitis C recurrence after liver transplant improves survival in both sustained responders and relapsers. Transplant International, 26(3), 281-289. https://doi.org/10.1111/tri.12027