Treatment of Genotype 4 Hepatitis C Recurring After Liver Transplantation Using a Combination of Pegylated Interferon Alfa-2a and Ribavirin

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Dig Dis Sci. 2011 Jan 8. [Epub ahead of print]

Treatment of Genotype 4 Hepatitis C Recurring After Liver Transplantation Using

a Combination of Pegylated Interferon Alfa-2a and Ribavirin.

Al-Hamoudi W, Mohamed H, Abaalkhail F, Kamel Y, Al-Masri N, Allam N, Alqahtani

S, Al-Sofayan M, Khalaf H, Al-Sebayel M, Al-Jedai A, Abdo A.

Gastroenterology Unit (59), Department of Medicine, College of Medicine, King

Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia, walhamoudi@....

Abstract

BACKGROUND: Hepatitis C virus (HCV) recurrence after liver transplantation (LT)

is universal and tends to be more aggressive. Data on post-transplant HCV

genotype 4 treatment is scarce. The aim of this study is to assess the safety

and efficacy of pegylated interferon alpha-2a (PEG-IFN) in combination with

ribavirin in the treatment of recurrent HCV genotype 4 after LT.

METHODS: Twenty-five patients infected with HCV genotype 4 were treated with

PEG-IFN alpha-2a at a dose of 180 ìg/week in addition to 800 mg/day of ribavirin

(the dose was adjusted within the tolerated range of 400-1,200 mg). Pretreatment

liver biopsies were obtained from all patients. Biochemical and virological

markers were assessed before, during, and after treatment.

RESULTS: Twenty-two patients (88%) achieved an early virological response (EVR)

(12 patients tested negative for HCV-RNA). Fifteen (60%) and 14 patients (56%)

achieved an end of treatment virological response (ETVR) and a sustained

virological response (SVR), respectively. Five patients had advanced

pretreatment liver fibrosis. Pretreatment ALT was elevated in 24 patients (96%).

The most common adverse effects were flu-like symptoms and cytopenia. Eighteen

patients (72%) required erythropoietin alpha and/or granulocyte-colony

stimulating factor as a supportive measure. One patient developed severe

rejection complicated by sepsis, renal failure, and death. Other adverse effects

included depression, mild rejection, impotence, itching, and vitiligo.

CONCLUSIONS: Post-transplant treatment with pegylated interferon alpha-2a and

ribavirin achieved SVR in 56% of liver transplant recipients with chronic HCV

genotype 4 infection. The combination was relatively safe and exhibited a low

rate of treatment withdrawal.

PMID: 21221800 [PubMed - as supplied by publisher]

[Guest guest]

Dig Dis Sci. 2011 Jan 8. [Epub ahead of print]

Treatment of Genotype 4 Hepatitis C Recurring After Liver Transplantation Using

a Combination of Pegylated Interferon Alfa-2a and Ribavirin.

Al-Hamoudi W, Mohamed H, Abaalkhail F, Kamel Y, Al-Masri N, Allam N, Alqahtani

S, Al-Sofayan M, Khalaf H, Al-Sebayel M, Al-Jedai A, Abdo A.

Gastroenterology Unit (59), Department of Medicine, College of Medicine, King

Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia, walhamoudi@....

Abstract

BACKGROUND: Hepatitis C virus (HCV) recurrence after liver transplantation (LT)

is universal and tends to be more aggressive. Data on post-transplant HCV

genotype 4 treatment is scarce. The aim of this study is to assess the safety

and efficacy of pegylated interferon alpha-2a (PEG-IFN) in combination with

ribavirin in the treatment of recurrent HCV genotype 4 after LT.

METHODS: Twenty-five patients infected with HCV genotype 4 were treated with

PEG-IFN alpha-2a at a dose of 180 ìg/week in addition to 800 mg/day of ribavirin

(the dose was adjusted within the tolerated range of 400-1,200 mg). Pretreatment

liver biopsies were obtained from all patients. Biochemical and virological

markers were assessed before, during, and after treatment.

RESULTS: Twenty-two patients (88%) achieved an early virological response (EVR)

(12 patients tested negative for HCV-RNA). Fifteen (60%) and 14 patients (56%)

achieved an end of treatment virological response (ETVR) and a sustained

virological response (SVR), respectively. Five patients had advanced

pretreatment liver fibrosis. Pretreatment ALT was elevated in 24 patients (96%).

The most common adverse effects were flu-like symptoms and cytopenia. Eighteen

patients (72%) required erythropoietin alpha and/or granulocyte-colony

stimulating factor as a supportive measure. One patient developed severe

rejection complicated by sepsis, renal failure, and death. Other adverse effects

included depression, mild rejection, impotence, itching, and vitiligo.

CONCLUSIONS: Post-transplant treatment with pegylated interferon alpha-2a and

ribavirin achieved SVR in 56% of liver transplant recipients with chronic HCV

genotype 4 infection. The combination was relatively safe and exhibited a low

rate of treatment withdrawal.

PMID: 21221800 [PubMed - as supplied by publisher]