Cyclosporine A-Based Immunosuppression Reduces Relapse Rate After Antiviral Therapy in Transplanted Patients With Hepatitis C Virus Infection: A Large Multicenter Cohort Study

被引：27

作者：

Castells, Ll. ^{[1
]}

Campos, I. ^{[1
]}

Bilbao, I. ^{[1
]}

Navasa, M. ^{[2
]}

Carrion, J. ^{[2
]}

Forns, X. ^{[2
]}

Berenguer, M. ^{[3
]}

Aguilera, V. ^{[3
]}

Prieto, M. ^{[3
]}

Fernandez, I. ^{[4
]}

Meneu, J. C. ^{[4
]}

Ulloa, E. ^{[4
]}

Fernandez, J. R. ^{[5
]}

Suarez, M. J. ^{[5
]}

Pascasio, J. M. ^{[6
]}

Sousa, J. M. ^{[6
]}

Casanovas, T. ^{[7
]}

Baliella, C. ^{[7
]}

Barcena, R. ^{[8
]}

Rodriguez, M. ^{[8
]}

de la Mata, M. ^{[9
]}

Barrera, P. ^{[9
]}

Salcedo, M. ^{[10
]}

Banares, R. ^{[10
]}

Otero, A. ^{[11
]}

Suarez, F. ^{[11
]}

Banos, I. ^{[12
]}

Tome, S. ^{[13
]}

Herrero, I. ^{[14
]}

Guilera, M. ^{[15
]}

机构：

[1] H Vall Hebron, Barcelona, Spain

[2] H Clin, Barcelona, Spain

[3] H La Fe, Valencia, Spain

[4] H 12 Octubre, Madrid, Spain

[5] H Cruces Gurutzeta, Bilbao, Spain

[6] H Univ Virgen del Rocio, Seville, Spain

[7] H Bellvitge, Lhospitalet De Llobregat, Spain

[8] H Ramon y Cajal, Madrid, Spain

[9] H Univ Reina Sofia, Cordoba, Spain

[10] H Gen Gregorio Maranon, Madrid, Spain

[11] Hosp Juan Canalejo, Coruna, Spain

[12] H Puerta de Hierro, Madrid, Spain

[13] H Clin Univ Santiago Compostela, Santiago De Compostela, Spain

[14] Univ Navarra Clin, Pamplona, Spain

[15] Novartis Novartis Pharmaceut SA, Barcelona, Spain

来源：

TRANSPLANTATION | 2011年 / 92卷 / 03期

关键词：

HCV; SVR; Antiviral treatment; Immunosuppression; SUSTAINED VIROLOGICAL RESPONSE; DONOR LIVER-TRANSPLANTATION; PEGYLATED INTERFERON; CALCINEURIN INHIBITORS; RIBAVIRIN THERAPY; RECIPIENTS; EFFICACY; RECURRENCE; PREDICTORS; COMBINATION;

D O I：

10.1097/TP.0b013e318223d836

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The influence of immunosuppression on the response to antiviral treatment in recurrent hepatitis C is still under debate. The purpose of this study was to identify those factors that might predict sustained viral response and relapse. Methods. The ReViS-TC, a multicenter cohort study conducted in 14 Spanish liver centers, included data from liver transplant recipients from January 2000 to December 2006 who had recurrent hepatitis C virus and who had undergone antiviral treatment with pegylated interferon plus ribavirin. Sustained virological response (SVR) and viral relapse were evaluated. A multivariate logistic regression model was used to investigate host, donor, and therapeutic factors associated with SVR and relapse. Results. The analysis included 410 patients, 30% treated with cyclosporine A (CsA) and 70% with tacrolimus. SVR was achieved in 48% of patients with CsA and in 37% with tacrolimus (P=0.037), with a relapse rate of 18% and 36%, respectively (P=0.008). In the multivariate model, the administration of CsA (odds ratio [OR] 0.37, P=0.021) in conjunction with a longer antiviral treatment duration (OR 0.86, P=0.024) correlated with lower relapse rate, whereas the older age of the donor (OR 1.03, P=0.006) and the presence of genotype 1 (OR 3.45, P=0.032) were associated with a higher probability of relapse. Conclusions. Our results suggest that the use of CsA-based immunosuppression regimens and longer treatment duration may protect patients against viral relapse after a positive response to pegylated interferon plus ribavirin therapy. These data need to be further confirmed in clinical trials.

引用

页码：334 / 340

页数：7

共 36 条

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