Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation.

• Ueda, Yoshihide

• Kaido, Toshimi

• Ogura, Yasuhiro

• Ogawa, Kohei

• Yoshizawa, Atsushi

• Hata, Koichiro

• Fujimoto, Yasuhiro

• Miyagawa-Hayashino, Aya

• Haga, Hironori

• Marusawa, Hiroyuki

• Teramukai, Satoshi

• Uemoto, Shinji

• Chiba, Tsutomu

Abstract

[Background]Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events. [Methods]A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011. [Results]Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables–pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype–remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found. [Conclusions]Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy.

Journal

• PloS one

  PloS one 8 (3), 2013-03-07

Details

• CRID: 1050282810746395648
• NII Article ID: 120005244568
• ISSN: 19326203
• HANDLE: 2433/173624
• Text Lang: en
• Article Type: journal article
• Data Source:
  • IRDB
  • CiNii Articles