Kornberg Arno, Küpper Bernadett, Tannapfel Andrea, Thrum Katharina, Bärthel Erik, Habrecht Ola, Settmacher Utz
Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University, Jena, Germany.
Transplantation. 2008 Aug 15;86(3):469-73. doi: 10.1097/TP.0b013e31817c0e20.
The aim of this study was to analyze the impact of virological response to long-term antiviral therapy using interferon plus ribavirin on survival of 30 liver transplant patients with recurrent hepatitis C. Mean treatment duration is currently 46 months (range: 3-144 months). Sustained clearance of serum hepatitis C virus RNA was achieved in 18 patients (60%). Allograft biopsies demonstrated fibrosis progression in seven virological nonresponders (66.6%), and none of the recipients with viral elimination (0%; P<0.001). Univariately, low pretransplant viral loads, the absence of cytomegalovirus infection, as well as biochemical and virological response to antiviral therapy indicated a positive impact on outcome (P<0.05). Only antiviral treatment induced clearance of viremia, however, was identified as independent predictor of long-term survival (P=0.02). Our data indicate that an antiviral combination should aim at viral eradication in liver transplant patients with recurrent hepatitis C, because it improves survival.
本研究旨在分析使用干扰素联合利巴韦林进行长期抗病毒治疗的病毒学反应对30例复发性丙型肝炎肝移植患者生存的影响。目前平均治疗持续时间为46个月（范围：3 - 144个月）。18例患者（60%）实现了血清丙型肝炎病毒RNA的持续清除。同种异体肝活检显示，7例病毒学无应答者（66.6%）出现纤维化进展，而病毒清除的受者无一例出现（0%；P<0.001）。单因素分析显示，移植前病毒载量低、无巨细胞病毒感染以及对抗病毒治疗的生化和病毒学反应均对预后有积极影响（P<0.05）。然而，只有抗病毒治疗诱导的病毒血症清除被确定为长期生存的独立预测因素（P = 0.02）。我们的数据表明，对于复发性丙型肝炎肝移植患者，抗病毒联合治疗应旨在根除病毒，因为这可提高生存率。
