After liver transplantation infection of the graft with the hepatitis C virus is almost universal. This leads to the development of chronic hepatitis and cirrhosis in a significant proportion of patients.
One of the possible strategies to prevent recurrence of hepatitis C is to eradicate hepatitis C virus prior to liver transplantation.
A team of Spanish doctors evaluated the efficacy and safety of antiviral therapy to prevent hepatitis C recurrence in 30 patients with hepatitis C and cirrhosis awaiting liver transplantation.
Antiviral therapy was initiated when the expected time for liver transplantation was less than 4 months away and continued until the transplant took place. The median duration of treatment was 12 weeks.
Antiviral therapy consisted of interferon-2b (3 MU/day) and ribavirin (800 mg/day).
9 out of the 30 patients achieved a virological response and 21 did not respond to therapy. Viral load decreased in 9 of the 21 non-responders during treatment.
The 9 patients who responded to antiviral therapy have since undergone liver transplantation. 6 of the 9 patients remain free of infection after a median follow-up of 46 weeks, while hepatitis C viral infection recurred in the remaining 3.
Side effects were frequent and dose reduction was necessary in 19 of the 30 patients.
|30% of patients had a virological response to antiviral therapy|
|Journal of Hepatology|
The authors of the study conclude “Our data support the utilization of antiviral therapy in hepatitis C-infected patients awaiting liver transplantation as one of the strategies to prevent hepatitis C recurrence after liver transplantation.”
However, in an editorial which appears in the same issue of The Journal of Hepatology, Dr Jean-Pierre Zarski adds a note of caution.
"Antiviral therapy should be considered experimental and not be administered outside of prospective trials."