Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto, Japan.
Transplantation. 2010 Sep 27;90(6):661-5. doi: 10.1097/TP.0b013e3181d2bfca.
The efficacy of combination therapy with pegylated interferon and ribavirin for recurrent hepatitis C genotype 1 after liver transplantation is limited. In this study, we designed an individualized treatment regimen with pegylated interferon and ribavirin for recurrent hepatitis C based on individual viral responses.
Thirty-four patients with recurrent hepatitis C genotype 1b after living-donor liver transplantation received combination therapy with pegylated interferon α-2b and ribavirin. Treatment was continued for an additional 12 months after serum hepatitis C virus (HCV) RNA became undetectable.
Of the 34 patients, 18 became negative for serum HCV RNA within 12 months (range, 1.2-9.9 months; median, 4.0 months). The treatment for the 18 patients was individualized by adding a further 12 months of treatment after the disappearance of serum HCV RNA, resulting in treatment durations of 13.2 to 21.9 months (median, 16.0 months). Notably, 17 (94%) of the 18 patients who received the individualized extended treatment achieved sustained virologic response (SVR), resulting in a 50% SVR rate. Six patients (18%) discontinued the treatment, but none of the 18 patients who received the extended protocol withdrew from the study.
Individualized extension of combination therapy with pegylated interferon and ribavirin for recurrent hepatitis C after liver transplantation resulted in a high SVR rate and good tolerability.
聚乙二醇干扰素联合利巴韦林治疗肝移植后复发的丙型肝炎基因型 1 的疗效有限。本研究根据个体病毒应答情况，设计了聚乙二醇干扰素联合利巴韦林治疗复发丙型肝炎的个体化治疗方案。
34 例肝移植后丙型肝炎基因型 1b 复发患者接受聚乙二醇干扰素α-2b 联合利巴韦林治疗。血清丙型肝炎病毒（HCV）RNA 检测不到后，再继续治疗 12 个月。
34 例患者中，18 例在 12 个月内（1.2-9.9 个月，中位数 4.0 个月）血清 HCV RNA 转为阴性。对 18 例血清 HCV RNA 消失的患者进行个体化治疗，在停止治疗后再延长 12 个月，治疗时间为 13.2-21.9 个月（中位数 16.0 个月）。值得注意的是，17 例（94%）接受个体化延长治疗的患者获得持续病毒学应答（SVR），SVR 率为 50%。6 例（18%）患者停止治疗，但没有 18 例接受延长方案的患者退出研究。
肝移植后复发丙型肝炎患者个体化延长聚乙二醇干扰素联合利巴韦林治疗可获得较高的 SVR 率和良好的耐受性。
