Efficacy of Interferon β Combined With Cyclosporine Induction and Intensified Therapy for Retreatment of Chronic Hepatitis C

• Published in: Transplantation proceedings 2009, Vol.41 (1), p.246-249
• Main Authors: Inoue, K, Watanabe, T, Yamada, M, Yoshikumi, H, Ogawa, O, Yoshiba, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antiviral Agents - therapeutic use; Biological and medical sciences; Cyclosporine - therapeutic use; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - surgery; Human viral diseases; Humans; Immunosuppressive Agents - therapeutic use; Infectious diseases; Interferon-alpha - therapeutic use; Interferon-beta - therapeutic use; Liver Transplantation; Male; Medical sciences; Middle Aged; Polyethylene Glycols - therapeutic use; Postoperative Complications - virology; Recombinant Proteins; Recurrence; Ribavirin - therapeutic use; Safety; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Treatment Failure; Treatment Outcome; Viral diseases; Viral hepatitis
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2008.10.056

Abstract Objective Hepatitis C virus (HCV) infection is a major burden after liver transplantation. There is no effective treatment for these patients, therefore management is challenging. Cyclophilins are essential host factors for HCV replication. We have reported herein the efficacy of divided administration of interferon (IFN) β plus cyclosporine for chronic hepatitis C patients who failed pegylated (Peg)-IFN or IFN combined ribavirin treatment. Patients and Methods We prospectively enrolled 59 patients (median age, 63 years) with genotype 1b who failed to respond to the combinations of IFN plus ribavirin or Peg-IFN plus ribavirin. Our treatment involved induction, intensified, and maintenance therapies. The induction therapy prescribed intravenous 1 MU IFN β every 4 hours for the first 3 days, 1.5 MU IFN β every 6 hours for the next 4 days, and then 2 MU IFN β every 8 hours for 3 weeks. The intensified therapy was the induction therapy shortened to 2 weeks. The maintenance therapy involved Peg-IFN α 2b and ribavirin. Cyclosporine was given 4 times daily during the induction and intensified therapies. Ribavirin was given twice daily during the maintenance phase. Results The end treatment and sustained virological response rates in the present study were 73% (43/59) and 59% (35/59), respectively. The relapse rate was 19% (8/43). Sixteen percent of patients (3/19) were nonresponders. All adverse effects were reversible. The treatment protocol was well tolerated. Conclusion Our protocol should be effective for patients who have failed previous combination therapies.