The research team, from the University of Bologna, Italy, analyzed the clinical records of all the patients transplanted for hepatitis C virus (HCV)-related liver disease between 1991 and 1997.
They assessed 80 consecutive HCV-positive patients who survived more than 1 month after transplantation. These patients were followed for a median of 45 months.
Diagnosis of recurrent chronic hepatitis C was made in 38 patients (48%), of whom 22 had moderate/severe chronic hepatitis.
Decompensated cirrhosis occurred in six patients (8%).
| Recurrent hepatitis C 36% with higher prednisone dose.|
The team found no difference in patient survival between patients with and without hepatitis C recurrence.
Furthermore, no association was found between recurrent hepatitis C and presumed risk factors.
However, the method of tapering off corticosteroids was significantly associated with both hepatitis C recurrence and the severity of hepatitis.
The research team discovered that in patients receiving a higher prednisone dose 12 months after transplantation, recurrent hepatitis C was 36% versus 67% (odds ratio, 3.6).
Additionally, in patients receiving a higher prednisone dose 6 months after transplantation, moderate/severe chronic hepatitis C was 40% versus 89% (odds ratio, 0.08).
Finally, prednisone dose at month 6 was significantly associated with disease-free survival of the liver graft.
Dr Stefano Brillanti's team concluded, "Our results seem to indicate that in HCV-infected liver transplant recipients, a long-term treatment with corticosteroids, slowly tapered off over time, may prevent the more aggressive forms of recurrent liver disease".