Garcia José Huygens Parente, Araújo Filho Antônio Haroldo de, Braga Lucia Libanez Bessa Campelo, Viana Cyntia Ferreira Gomes, Rocha Tarciso Daniel Santos, Pereira Karla Brandão
Departamento de Cirurgia de Fortaleza, Universidade Federal do Ceará, Fortaleza, CE, BR.
Hospital Universitário Walter Cantídio, Fortaleza, CE, BR.
Arq Gastroenterol. 2015 Jul-Sep;52(3):216-21. doi: 10.1590/S0004-28032015000300012.
Treatment of hepatitis C virus infection in post-transplantation patients is a challenge due to poor tolerance and low success rates.
To determine the response rate to pegylated interferon and ribavirin in post-liver transplant patients with hepatitis C recurrence.
Between 18 May 2002 and 18 December 2011, 601 patients underwent liver transplantation at our service (Hospital Universitário Walter Cantídio, University of Ceará), 176 (29.2%) of whom were hepatitis C virus positive. Forty received antiviral therapy and were included in this cohort study. Twenty-eight (70%) completed the treatment protocol, which consisted of pegylated interferon and ribavirin for 48 weeks.
The sustained virological response rate was 55% according to intention-to-treat analysis. Recipient age and exposure to antiviral drugs prior to liver transplantation were associated with sustained virological response in the multivariate analysis. Patients were followed for 57 months on the average. Survival at 1 and 5 years was 100% in responders, versus 100% and 78%, respectively, in non-responders.
Sustained virological response rates were satisfactory in our series of liver transplantation patients, and decreased with increasing recipient age. Non-exposure to antiviral drugs prior to liver transplantation was positively associated with sustained virological response. The overall survival of responders and non-responders was similar.
由于耐受性差和成功率低，肝移植后患者的丙型肝炎病毒感染治疗颇具挑战。
确定聚乙二醇干扰素和利巴韦林对肝移植后丙型肝炎复发患者的应答率。
2002年5月18日至2011年12月18日期间，601例患者在我们的服务机构（塞阿拉大学沃尔特·坎蒂迪奥大学医院）接受了肝移植，其中176例（29.2%）为丙型肝炎病毒阳性。40例接受了抗病毒治疗并纳入本队列研究。28例（70%）完成了治疗方案，该方案包括使用聚乙二醇干扰素和利巴韦林治疗48周。
根据意向性分析，持续病毒学应答率为55%。多因素分析显示，受者年龄和肝移植前接触抗病毒药物与持续病毒学应答相关。患者平均随访57个月。应答者1年和5年生存率均为100%，无应答者分别为100%和78%。
在我们的肝移植患者系列中，持续病毒学应答率令人满意，且随受者年龄增加而降低。肝移植前未接触抗病毒药物与持续病毒学应答呈正相关。应答者和无应答者的总体生存率相似。
