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 21 February 2018

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Antiviral therapy of patients for patients awaiting liver transplantation: A strategy to prevent hepatitis C recurrence after transplantation

The utilization of antiviral therapy in hepatitis C virus infected patients awaiting liver transplantation is a useful strategy to prevent hepatitis C recurrence after transplantation, according to a study published in The Journal of Hepatology.

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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.

30% of patients had a virological response to antiviral therapy
Journal of Hepatology
Side effects were frequent and dose reduction was necessary in 19 of the 30 patients.

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."

Journal of Hepatology 2003; 39(3): 389-396
15 August 2003

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