Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation.
<h4>Background</h4>Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral t...
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2013
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oai:doaj.org-article:c9f14028b6a04c89bd6407ea51c262d92021-11-18T07:54:22ZPretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation.1932-620310.1371/journal.pone.0058380https://doaj.org/article/c9f14028b6a04c89bd6407ea51c262d92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23505497/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events.<h4>Methods</h4>A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011.<h4>Results</h4>Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables-pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype-remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found.<h4>Conclusions</h4>Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy.<h4>Trial registration</h4>UMIN-CTR UMIN000003286.Yoshihide UedaToshimi KaidoYasuhiro OguraKohei OgawaAtsushi YoshizawaKoichiro HataYasuhiro FujimotoAya Miyagawa-HayashinoHironori HagaHiroyuki MarusawaSatoshi TeramukaiShinji UemotoTsutomu ChibaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58380 (2013) |
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Medicine R Science Q |
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Medicine R Science Q Yoshihide Ueda Toshimi Kaido Yasuhiro Ogura Kohei Ogawa Atsushi Yoshizawa Koichiro Hata Yasuhiro Fujimoto Aya Miyagawa-Hayashino Hironori Haga Hiroyuki Marusawa Satoshi Teramukai Shinji Uemoto Tsutomu Chiba Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| description |
<h4>Background</h4>Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events.<h4>Methods</h4>A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011.<h4>Results</h4>Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables-pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype-remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found.<h4>Conclusions</h4>Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy.<h4>Trial registration</h4>UMIN-CTR UMIN000003286. |
| format |
article |
| author |
Yoshihide Ueda Toshimi Kaido Yasuhiro Ogura Kohei Ogawa Atsushi Yoshizawa Koichiro Hata Yasuhiro Fujimoto Aya Miyagawa-Hayashino Hironori Haga Hiroyuki Marusawa Satoshi Teramukai Shinji Uemoto Tsutomu Chiba |
| author_facet |
Yoshihide Ueda Toshimi Kaido Yasuhiro Ogura Kohei Ogawa Atsushi Yoshizawa Koichiro Hata Yasuhiro Fujimoto Aya Miyagawa-Hayashino Hironori Haga Hiroyuki Marusawa Satoshi Teramukai Shinji Uemoto Tsutomu Chiba |
| author_sort |
Yoshihide Ueda |
| title |
Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| title_short |
Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| title_full |
Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| title_fullStr |
Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| title_full_unstemmed |
Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation. |
| title_sort |
pretransplant serum hepatitis c virus rna levels predict response to antiviral treatment after living donor liver transplantation. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/c9f14028b6a04c89bd6407ea51c262d9 |
| work_keys_str_mv |
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| _version_ |
1718422795796348928 |