The effect of long-term maintenance of steroids on Hepatitis C virus recurrence after liver transplantation is still controversial.
Dr Marco Vivarelli and colleagues from Italy conducted a prospective multicenter trial at the centres of Bologna and Padua in Italy from 2002.
|96% in Group 1 had Hepatitis C virus recurrence|
|Journal of Hepatology|
The team identified 47 eligible Hepatitis C virus positive liver transplantation recipients.
The patients received 2 different steroid schedules in association with tacrolimus.
The team randomized 23 patients to Group 1, who received rapid tapering and withdrawal 91 days after liver transplantation.
Group 2 included 16 patients who received slow tapering and withdrawal 25 months after liver transplantation.
Donor and recipient characteristics were similar in the 2 groups.
Median follow-up was 841 days.
The research team performed 100 liver biopsies, and every patient had a biopsy at month 12.
The researchers found that 96% of patients in Group 1, and 94% in Group 2 had histologically-confirmed Hepatitis C virus recurrence.
The team reported that 12-month histology showed advanced fibrosis in 42% of the patients in Group 1 vs 8% in Group 2.
The researchers found that 1-and 2-year advanced fibrosis-free survival were 65% in Group 1, and 94% in Group 2.
Dr Vivarelli's team concluded, "Slow tapering of steroids reduced the progression of recurrent Hepatitis C after liver transplantation."