The management issues of transplant patients with hepatitis C virus (HCV) are complex, and interferon therapy is often ineffective.
Dr Slapak-Green and colleagues from Miami, America undertook a retrospective review of liver-transplant recipients suffering from HCV recurrence that were treated with pegylated alpha-2b interferon and ribavirin.
Participants received combination pegylated alpha-2b interferon (1.5 mcg/kg/wk) and ribavirin (400-600 mg/day) and therapy intended for at least 48 weeks.
The researchers then recorded complications, including neutropenia (<750 cells), anemia (hemoglobin <8 g) with and without treatment consisting of blood transfusions, erythropoietin, or dose reduction of ribavirin, and depression.
The research team determined a diagnosis of hepatitis C virus recurrence by an increase in liver chemistries, histopathologic findings with inflammation along with viral recurrence using the COBAS AMPLICOR HCV test.
| 28% of patients who were naïve to therapy and 21% of nonresponders were HCV nondetectable at the end of 48 weeks of therapy|
The researchers included a total of 57 liver-transplant recipients in the study.
The participants were separated into Group 1 , 29 participants naive to therapy and Group 2, 28 nonresponders.
The research team administered at least 6 months of interferon and ribavirin therapy.
The researchers observed that 8 (28) patients in group 1 and six (21%) patients in group 2 were HCV nondetectable at the end of 48 weeks of therapy.
In addition, the research team noted that ribavirin therapy was decreased in 13 of 29 (45%) for group 1 and 11 of 28 (39%) in group 2.
Therapeutic interventions were 4 of 57 (7%) blood transfusions, 23 of 57 (40%) erythropoietin, and 17 of 57 (30%) filgrastim.
Dr Slapak-Green concluded, "Combination pegylated interferon with ribavirin appears to be effective therapy in HCV recurrence and in HCV nonresponsive to interferon and ribavirin."
She added, "This data reveals the difficulty and caution that must be taken when treating HCV-R liver-transplant recipients with combination pegylated alpha-2b interferon and ribavirin therapy."