Individualized Extension of Pegylated Interferon Plus Ribavirin Therapy for Recurrent Hepatitis C Genotype 1b After Living-Donor Liver Transplantation

Background. The efficacy of combination therapy with pegylated interferon and ribavirin for recurrent hepatitis C genotype 1 after liver transplantation is limited. In this study, we designed an individualized treatment regimen with pegylated interferon and ribavirin for recurrent hepatitis C based on individual viral responses. Methods. Thirty-four patients with recurrent hepatitis C genotype 1b after living-donor liver transplantation received combination therapy with pegylated interferon alpha-2b and ribavirin. Treatment was continued for an additional 12 months after serum hepatitis C virus (HCV) RNA became undetectable. Results. Of the 34 patients, 18 became negative for serum HCV RNA within 12 months (range, 1.2-9.9 months; median, 4.0 months). The treatment for the 18 patients was individualized by adding a further 12 months of treatment after the disappearance of serum HCV RNA, resulting in treatment durations of 13.2 to 21.9 months (median, 16.0 months). Notably, 17 (94%) of the 18 patients who received the individualized extended treatment achieved sustained virologic response (SVR), resulting in a 50% SVR rate. Six patients (18%) discontinued the treatment, but none of the 18 patients who received the extended protocol withdrew from the study. Conclusions. Individualized extension of combination therapy with pegylated interferon and ribavirin for recurrent hepatitis C after liver transplantation resulted in a high SVR rate and good tolerability.