Long-term Maintenance of Sustained Virological Response in Liver Transplant Recipients Treated for Recurrent Hepatitis C

Dig Liver Dis. 2014 May;46(5):440-5. doi: 10.1016/j.dld.2014.01.157. Epub 2014 Mar 11.

Abstract

Background: The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival.

Aim: To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis C recurrence.

Methods: 436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis C recurrence were retrospectively evaluated.

Results: The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008).

Conclusions: Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.

Keywords: HCV antiviral treatment; Hepatitis C recurrence; Liver transplantation; Sustained viral response.

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Genotype
  • Graft Survival
  • Hepacivirus / genetics*
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / mortality
  • Humans
  • Interferon-alpha / therapeutic use
  • Interferons
  • Interleukins / genetics
  • Liver Transplantation* / mortality
  • Maintenance Chemotherapy / methods
  • Male
  • Middle Aged
  • Polyethylene Glycols / therapeutic use
  • RNA, Viral / blood*
  • Recombinant Proteins / therapeutic use
  • Recurrence
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Survival Rate
  • Time Factors

Substances

  • Antiviral Agents
  • IFNL3 protein, human
  • Interferon-alpha
  • Interleukins
  • RNA, Viral
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • Interferons
  • peginterferon alfa-2a