Sustained virological response to antiviral therapy reduces mortality in HCV reinfection after liver transplantation

Background/Aims: HCV infection recurs almost in all HCV-positive patients receiving liver transplantation and carries a poor prognosis. Aim of this study was to analyze efficacy and effect on survival of antiviral therapy in this clinical setting. Methods: Pegylated-interferon alpha-2b and ribavirin were administered at a dose of 1 mu g/kg of bwt weekly and 600-800 mg/ day. Planned duration of treatment was 24 or 48 weeks according to HCV genotype. Patients who failed to respond at week 24 were considered as non-responders. Results: 61 patients were enrolled. According to intention-to-treat analysis, 44 (72%) patients were considered as treatment failure (31 non-responders, 4 relapsers, 9 dropout). Sustained virological response was achieved in 17 cases (28%). Genotype 2, higher doses of antivirals; and absence of histological cirrhosis were predictors of sustained virological response. In the follow up, patients with sustained virological response had a significantly lower mortality compared to patients with treatment failure (chi(2) = 6.9; P < 0.01). Conclusions: Response rate to antiviral therapy in HCV reinfection after liver transplantation is higher if a full dose of antiviral drugs is administered and if treatment starts before histological cirrhosis has developed. Sustained virological response improves patient survival. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.