Patients with advanced hepatitis C virus are at risk of death and are candidates for liver transplantation.
After transplantation, hepatitis C recurs and may rapidly progress to cirrhosis and graft loss.
Treatment is needed to prevent progression of disease and minimize recurrence after liver transplantation.
Dr Everson and colleagues from Denver of antiviral therapy in the treatment of patients with advanced hepatits C.
The researchers evaluated the effectiveness, tolerability, and outcome of a low accelerating dose regimen.
The research team treated 124 patients, of which 81 were male between the ages of 37 and 71 years, with low accelerating dose regimen.
|Sustained virological response was 13% in patients infected with genotype 1 hepatitis C|
The team reported that 63% had clinical complications of cirrhosis including ascites, spontaneous bacterial peritonitis, varices, variceal hemorrhage, and encephalopathy.
The mean Child-Turcotte-Pugh score was 7, and the mean MELD score was 11.
The team noted that 56 patients were Child-Turcotte-Pugh class A, 45 were class B, and 23 were class C.
The researchers observed that 46% were hepatitis C RNA-negative at end of treatment, and 24% were hepatitis C RNA-negative at last follow-up.
Sustained virological response occurred in 13% of patients infected with genotype 1 hepatitis C and 50% in patients infected with non-1 genotypes.
The researchers noted that with non-1 genotype, Child-Turcotte-Pugh class A, and ability to tolerate full dose and duration of treatment were predictors of sustained virological response.
In addition, the team found that 12 of 15 patients who were hepatitis C RNA-negative before transplantation remained hepatitis C RNA-negative 6 months or more after transplantation.
Dr Everson's team concludes, “In a sizeable proportion of patients with advanced hepatitis C, low accelerating dose regimen may render blood free of hepatitis C RNA, stabilize clinical course, and prevent posttransplantation recurrence.”