Outcome of long-term ribavirin therapy for recurrent hepatitis C after liver transplantation

被引:55
作者
Cattral, MS [1 ]
Hemming, AW [1 ]
Wanless, IR [1 ]
Al Ashgar, H [1 ]
Krajden, M [1 ]
Lilly, L [1 ]
Greig, PD [1 ]
Levy, GA [1 ]
机构
[1] Univ Toronto, Toronto Hosp, Multiorgan Transplantat Program, Toronto, ON M5G 2C4, Canada
关键词
D O I
10.1097/00007890-199905150-00014
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Ribavirin therapy was initiated at a median of 181 days after liver transplantation in 18 patients with persistent elevation of alanine aminotransferase values and biopsy-proven hepatitis, and continued for 23 months (12-44 months). All patients had a prompt biochemical response, with alanine aminotransferase decreasing by 69%; complete normalization occurred in 5 (28%). Serum hepatitis C virus RNA levels did not change during therapy. Liver biopsies obtained after 17 months (9-38 months) of therapy showed no im provement in necroinflammation, However, worsening of fibrosis occurred in 12 patients; and cirrhosis developed in 5 patients (28%), with 3 patients progressing to graft failure. Biopsies from 27 untreated patients who did not fulfill treatment criteria (median follow-up, 38 months) and 4 patients who received 3 months of ribavirin (44 months) showed cirrhosis in 11 and 75%, respectively. Patient and graft survival rates for treated and untreated patients were similar. Although ribavirin improves alanine aminotransferase, it does not prevent the development or progression of fibrosis in patients with recurrent hepatitis C virus.
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收藏
页码:1277 / 1280
页数:4
相关论文
共 11 条
[1]   Pilot study of the combination of interferon alfa and ribavirin as therapy of recurrent hepatitis C after liver transplantation [J].
Bizollon, T ;
Palazzo, U ;
Ducerf, C ;
Chevallier, M ;
Elliott, M ;
Baulieux, J ;
Pouyet, M ;
Trepo, C .
HEPATOLOGY, 1997, 26 (02) :500-504
[2]   Tolerance and efficacy of oral ribavirin treatment of chronic hepatitis C: A multicenter trial [J].
Bodenheimer, HC ;
Lindsay, KL ;
Davis, GL ;
Lewis, JH ;
Thung, SN ;
Seeff, LB .
HEPATOLOGY, 1997, 26 (02) :473-477
[3]   Long-term outcome of hepatitis C infection after liver transplantation [J].
Cane, EJ ;
Portmann, BC ;
Naoumov, NV ;
Smith, HM ;
Underhill, JA ;
Donaldson, PT ;
Maertens, G ;
Williams, R .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 334 (13) :815-820
[4]   A pilot study of ribavirin therapy for recurrent hepatitis C virus infection after liver transplantation [J].
Cattral, MS ;
Krajden, M ;
Wanless, IR ;
Rezig, M ;
Cameron, R ;
Greig, PD ;
Chung, SW ;
Levy, GA .
TRANSPLANTATION, 1996, 61 (10) :1483-1488
[5]  
DIBISCEGLIE AM, 1994, HEPATOLOGY, V21, P1109
[6]   REINFECTION OF LIVER GRAFT BY HEPATITIS-C VIRUS AFTER LIVER-TRANSPLANTATION [J].
FERAY, C ;
SAMUEL, D ;
THIERS, V ;
GIGOU, M ;
PICHON, F ;
BISMUTH, A ;
REYNES, M ;
MAISONNEUVE, P ;
BISMUTH, H ;
BRECHOT, C .
JOURNAL OF CLINICAL INVESTIGATION, 1992, 89 (04) :1361-1365
[7]   HISTOLOGICAL GRADING AND STAGING OF CHRONIC HEPATITIS [J].
ISHAK, K ;
BAPTISTA, A ;
BIANCHI, L ;
CALLEA, F ;
DEGROOTE, J ;
GUDAT, F ;
DENK, H ;
DESMET, V ;
KORB, G ;
MACSWEEN, RNM ;
PHILLIPS, MJ ;
PORTMANN, BG ;
POULSEN, H ;
SCHEUER, PJ ;
SCHMID, M ;
THALER, H .
JOURNAL OF HEPATOLOGY, 1995, 22 (06) :696-699
[8]  
Ning Q, 1998, J IMMUNOL, V160, P3487
[9]  
Ostojic R, 1997, HEPATOLOGY, V26, P105
[10]   Randomised trial of interferon α2b plus ribavirin for 48 weeks or for 24 weeks versus interferon α2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus [J].
Poynard, T ;
Marcellin, P ;
Lee, SS ;
Niederau, C ;
Minuk, GS ;
Ideo, G ;
Bain, V ;
Heathcote, J ;
Zeuzem, S ;
Trepo, C ;
Albrecht, J .
LANCET, 1998, 352 (9138) :1426-1432