Pegylated-interferon alpha 2b and ribavirin for recurrent hepatitis C: Methods (Part 1)

In: Recurrent hepatitis C

11 Sep 2012

Beginning in January 2002, treatment with PEG-IFN began in a total of 13 patients (10 men and three women) with recurrent HCV following LT (Table 1). These 13 patients represent one-third of the 39 HCV-positive LT recipients among the 144 LT recipients followed by the Southern Alberta Transplant Clinic in Calgary, Alberta. The mean age of these patients was 49.4 years (range 39.4 to 61.3 years) at the time of LT. Recurrent HCV was established histologically by liver biopsy in all patients. The average time between LT and biopsy-proven recurrence was 21.8 months (range 2.5 to 71.3 months). The grade and stage of histological recurrence is shown in Table 1. Upon biopsy, all patients had at least grade 1 inflammation, and all had elevated alanine aminotransferase (ALT) levels when antiviral therapy was introduced. Five patients had bridging fibrosis (stage 3) or established cirrhosis (stage 4) when therapy began. None of the patients in this series had fibrosing cholestatic recurrent HCV. Eight patients had genotype 1 HCV, with six patients having genotype 1b (46%) and two patients having genotype 1a (15%). Two patients had genotype 2 (15%), one had genotype 3 (7%), one had genotype 4 and one had genotype 6.

TABLE 1 Patient, histological and treatment characteristics in 13 patients with recurrent hepatitis C (HCV) following liver transplantation (LT)

Patient Patient characteristics Histological recurrence Treatment
Mean age at LT (years) Sex HCV genotype Drugs Rebetron after LT (months) Months after LT Grade Stage Started months after LT Type Duration(weeks)
1 46.1 F 2 S 11.5 1 0 13.9 P + R 43.3
2 44.3 M 6 T + S 4.3 2 1 5.9 P + R 48.0
3 51.7 M 1 T 2.5 2 1 5.5 P + R 11.7
4 39.4 F 1 C 71.3 2 2 73.2 P + R 48.0
5 45.6 M 1 C 39.0 2 2 45.5 P + R 38.4*
6 61.4 F 2 S 6.4 2 2 8.9 P + R 38.6
7t 44.3 M 3 C 10 20.3 2 2 24.1 P + R 33.4
8 52.6 M 1 T 7.3 3 2 8.5 P + R 48.0
9 50.0 M 1 S 6 12.9 3 3 16.2 P + R 2.4
10 53.3 M 1 C 32.9 3 3 33.2 P + R 6.7
11t 52.9 M 1 C 5 13.0 3 3 17.5 P 5.0
12t 55.5 M 1 C 9 45.0 2 4 51.3 P + R 93.0
13t 44.9 M 4 C 12 16.4 3 4 38.9 P + R 31.7
Average 49.4 21.8 26.4 34.5

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