Efficacy and safety of low accelerating dose regimen of interferon/ribavirin antiviral therapy in patients with hepatitis C virus recurrence after liver transplantation.

BACKGROUND

Achievement of sustained virological response (SVR) is the main goal of interferon/ribavirin (IFN/RBV) antiviral therapy in patients with hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT). In this study, we have retrospectively evaluated the efficacy and safety of low accelerating dose regimen (LADR) of IFN/RBV in patients with HCV recurrence after OLT.

MATERIAL AND METHODS

Thirty-one patients with HCV recurrent after OLT who were treated with LADR of antiviral therapy were analyzed in our study. Data of virological response (including rapid, early, end of treatment and sustained virological responses, designated as RVR, EVR, ETVR, and SVR, respectively) and liver histological change were collected.

RESULTS

All patients received tacrolimus (TAC) and/or mycophenolate mofetil (MMF) for immunosuppression. Seven patients (23%), 6 patients (19%), and 18 patients (58%) finished complete treatment (CT), complete duration (CD), and incomplete treatment (IT), respectively. Twenty-four patients (77%) achieved ETVR. Among them, 8 patients (33%) achieved SVR, while 16 (67%) patients relapsed within 24 weeks after the end of the treatment. Univariate analysis showed that pretreatment viral load (p=0.002) as well as treatment dose and duration (p<0.001) were positively associated with SVR. Flu-like side effects were observed in all patients and 17 (54.8%) discontinued treatment due to adverse events.

CONCLUSIONS

SVR achievement and tolerability to LADR of IFN/RBV therapy in our study are moderate in patients with HCV recurrence after liver transplantation. Pretreatment viral load and treatment dose and duration are positively related to SVR.