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 21 November 2017

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News

Tapering off steroids protects against hepatitis C recurrence after liver transplantation

A study, published in the latest issue of Liver Transplantation, finds that treatment with corticosteroids, tapered off over time, may prevent more aggressive forms of recurrent liver disease.

News image

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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.
Liver Transplantation

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".

Liver Transpl 2002; 8 (10): 884-9
08 October 2002

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