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2014, Number 2

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Ann Hepatol 2014; 13 (2)

Outcome of early vs. deferred antiviral treatment for recurrent hepatitis C in liver transplant recipients

Ornelas-Arroyo S, Méndez-Sánchez N
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Language: English
References: 8
Page: 160-162
PDF size: 71.39 Kb.


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Campos-Varela I, et al. Cirrhosis due to hepatitis C virus infection has become the most common indication for liver transplantation, however graft infection is virtually a rule leading to cirrhosis in 10% to 30% of patients in 5 to 7 years following transplantation. There are few high quality studies to guide treatment of HCV after liver transplantation. Combination therapy with interferon plus rivabirin has been associated with end of treatment response rates as high as approximately 50% and sustained virological response rates of over 20 % in some series. However the optimal time to begin the antiviral therapy still debatable and its usually based on the fibrosis stage. In this regard Castells evaluated the efficacy and safety of treatment with pegylated interferon and rivabirin in the acute phase of recurrent HCV after liver transplantation, when risk of acute rejection is presumably lower. Treatment with combined therapy yielded a sustained virological response of 34.7%. Although proven safe and effective the limited sample size and comparison with patients who did not receive antiviral therapy precluded identification of patients who might obtain the most benefit from this strategy.


REFERENCES

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  2. Castells L, Vargas V, Allende H, Bilbao I, Luis LJ, Margarit C, Esteban R et al. Combined treatment with pegylated interferon (a-2b) and rivabirin in the acute phase of hepatitis C virus recurrence after liver transplantation. J Hepatol 2005; 43: 53-9.

  3. Fukuhara T, Taketomi A, Motomura T, Okano S, Ninomiya A, Abe T, Uchiyama H, et al. Variants in IL28B in liver recipients and donor correlate with response to peg-interferon and rivabirin therapy for recurrent hepatitis C. Gastroenterology 2010; 139: 1577.

  4. Wan P, Xia Q, Zhang JJ, Li QG, Xu N, Zhang M, Chen XS, et al. Liver transplantation for hepatocellular carcinoma exceeding the Milan criteria: a single-center experience. J Cancer Res Clin Oncol 2013 Dec 30. [Epub ahead of print].

  5. Sherman M. Hepatocellular carcinoma: epidemiology, surveillance, and diagnosis. Semin Liver Dis. 2010; 30: 3-16.

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  8. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012; 908-43.




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C?MO CITAR (Vancouver)

Ann Hepatol. 2014;13