Influence of antiviral therapy in the long‐term outcome of recurrent hepatitis C virus infection following liver transplantation. Issue 4 (3rd June 2013)

• Record Type: Journal Article
• Authors: García‐Reyne, A.; Lumbreras, C.; Fernández, I.; Colina, F.; Abradelo, M.; Magan, P.; San‐Juan, R.; Manrique, A.; López‐Medrano, F.; Fuertes, A.; Lizasoain, M.; Moreno, E.; Aguado, J.M.
• Is Part Of: Transplant infectious disease. Volume 15:Issue 4(2013)
• Page Start: 405
• Page End: 415
• Publication Date: 2013-06-03
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12097
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12097-abs-0001"> <title>Abstract</title> <sec id="tid12097-sec-0001" sec-type="section"> <title>Introduction</title> <p>Severity of recurrent hepatitis C virus (HCV) infection in liver transplant recipients (LTR) is variable and the influence of different factors, including the administration of antiviral therapy in the long‐term outcome is controversial.</p> </sec> <sec id="tid12097-sec-0002" sec-type="section"> <title>Methods</title> <p>We analyzed the outcome of a cohort of HCV‐infected LTR who were transplanted in our institution. Patients were divided into 2 groups (severe and non‐severe HCV disease) depending on the presence of a fibrosis score of F ≥2 in the Scheuer index and/or fibrosing cholestasic hepatitis (FCH) in a graft biopsy. Risk factors were studied using logistic regression analysis. Survival of patients was estimated using Kaplan–Meier plots. A total of 146 patients were followed for a mean of 58 months.</p> </sec> <sec id="tid12097-sec-0003" sec-type="section"> <title>Results</title> <p>Fifty‐six (34%) patients developed severe HCV disease and showed shorter survival (<italic>P</italic> < 0.024). Donor age (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.02–1.06) and pre‐transplant viral load (VL) >10<sup>6</sup> UI/mL (OR: 3.5; 95% CI: 1.42–10.61) were the only factors associated with severe HCV infection. Over‐immunosuppression (OR: 2.3; 95% CI: 1.2–4.41) was specifically associated with the development of FCH. Overall, patient survival in recipients who received a full course of anti‐HCV therapy was higher than in patients who did not complete antiviral therapy (<italic>P</italic> = 0.004) or received no treatment (<italic>P</italic> = 0.007). Patients with non‐severe HCV infection have a higher probability of receiving a full course of antiviral therapy (<italic>P</italic> = 0.033).</p> </sec> <sec id="tid12097-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In conclusion, donor age, pre‐transplant VL, and over‐immunosuppression were associated with the long‐term development of severe HCV recurrence in liver grafts. Administration of a full course of antiviral therapy was associated with better survival.</p> </sec> </abstract>