- 作者：Valentina Rosa Bertuzzo ; Matteo Cescon ; Maria Cristina Morelli ; Paolo Di Gioia ; Mariarosa Tam¨¨ ; Stefania Lorenzini ; Pietro Andreone ; Giorgio Ercolani ; Massimo Del Gaudio ; Matteo Ravaioli ; Aless ; ro Cucchetti ; Aless ; ro Dazzi ; Antonietta D¡¯Errico-Grigioni ; Antonio Daniele Pinna
- 关键词：Antiviral treatment ; HCV recurrence ; Liver transplantation ; Non-responder
- 刊名：Digestive and Liver Disease
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：44
- 期：10
- 页码：861-867
- 全文大小：276 K
Background and aims
The management of patients treated for hepatitis C recurrence after liver transplantation and not achieving virological response following treatment with interferon plus ribavirin is controversial.Methods
A retrospective analysis of the outcomes of 70 patients non-responders to antiviral treatment after liver transplantation was performed. Twenty-one patients (30.0 % ; Group A) were treated for ¡Ü12 months and 49 (70.0 % ; Group B) for more than 12 months.
Results
The 2 groups were comparable for main demographic, clinical and pathological variables. Median duration of antiviral treatment was 8.2 months in Group A and 33.4 months in Group B. No patient achieved a complete virological response. The 5-year patient hepatitis C-related survival rate was 49.2 % in Group A and 88.3 % in Group B (P = 0.002), while the 5-year graft survival rate was 49.2 % in Group A and 85.9 % in Group B (P = 0.007). The median yearly fibrosis progression rate was 1.21 per year in Group A and 0.40 per year in Group B (P = 0.001).
Conclusions
Prolonged antiviral treatment showed an overall beneficial effect in transplanted patients with a recurrent hepatitis C infection and not responding to conventional therapy. The treatment should be continued as long as it is permitted, in order to improve clinical and histological outcomes.