Combination therapy with peginterferon alpha-2B and ribavirin in liver transplant recipients with recurrent HCV infection: preliminary results of an open prospective study

• Published in: Transplantation proceedings 2004-06, Vol.36 (5), p.1489-1491
• Main Authors: Beckebaum, S, Cicinnati, V.R, Zhang, X, Malago, M, Dirsch, O, Erim, Y, Frilling, A, Broelsch, C.E, Gerken, G
• Format: Article
• Language: English
• Subjects: Adult; Alanine Transaminase - blood; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Drug Administration Schedule; Drug Therapy, Combination; Female; Hepatitis C - drug therapy; Hepatitis C - surgery; Human viral diseases; Humans; Infectious diseases; Interferon-alpha - administration & dosage; Interferon-alpha - therapeutic use; Liver Function Tests; Liver Transplantation - physiology; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Polyethylene Glycols; Recombinant Proteins; Recurrence; Ribavirin - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Viral diseases; Viral hepatitis
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.05.017

Allograft reinfection with hepatitis C virus (HCV) in transplant recipients occurs commonly and represents a major concern in the transplant setting. Suppression of viral replication in HCV transplant patients should prevent or delay progression to cirrhosis and graft failure. In this ongoing study, we present preliminary data from a prospective trial of standard interferon (IFN) alpha-2b (2 million units daily) for 3 months and subsequent peginterferon (PEG IFN) alpha-2b (1.5 μg/kg/week) for 9 months. IFN therapy was combined with ribavirin (10 to 12 mg/kg). So far, HCV has become undetectable by qualitative PCR in 33% of patients while 25% had a reduction of HCV RNA to undetectable by the bDNA assay and 42% had no virological response after 6 months of therapy. A biochemical response was detected in 42% of patients. Improvement of inflammatory activity was observed in 42% of patients after 6 months. Anemia necessitated administration of erythropoietin in three patients and leukopenia, three patients granulocyte-colony stimulating factor (G-CSF) in three. In conclusion, we observed that daily IFN alpha-2b and subsequent PEG IFN alpha-2b therapy in combination with ribavirin provides biochemical and virological benefits in transplant recipients with established recurrent HCV infection.