Pegylated interferon plus ribavirin for recurrent Hepatitis C infection after liver transplantation in naive and non-responder patients on a stable immunosuppressive regimen

Background. Hepatitis C virus recurrence after liver transplantation is universal, leading to chronic hepatitis and cirrhosis. Aims and patients. We evaluated the efficacy and safety of pegylated interferon and ribavirin in 20 patients with recurrent Hepatitis C virus after liver transplantation (10 naive and 10 non-responders to a previous interferon course). Methods. Treatment consisted of pegylated interferon alfa-2b (1.0 mu g/kg once weekly) and ribavirin (600 mg/daily) for at least 6 months. Therapy continued for an additional 6 months only in patients with undetectable serum Hepatitis C virus-RNA or > 2 log drop from baseline levels. Results. Eleven out of 20 patients (55%) completed I year of treatment, Nine patients (45%) had undetectable Hepatitis C virus-RNA at the end of treatment, six of them were naives and three non-responders. In all of them, virological response persisted 6 months after discontinuation of therapy, so the sustained virological response rate was 60% in naive patients and 30% in non-responders. Conclusions. Our results suggest that pegylated interferon plus ribavirin combination therapy may be effective in patients with post-liver transplantation recurrent chronic Hepatitis C, even in those previously non-responders to interferon plus ribavirin. These results need to be confirmed by large studies. (c) 2005 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.