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Dig Liver Dis ; 46(5): 440-5, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24635906

RESUMO

BACKGROUND: The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival. AIM: To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis C recurrence. METHODS: 436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis C recurrence were retrospectively evaluated. RESULTS: The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008). CONCLUSIONS: Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.


Assuntos
Antivirais/uso terapêutico , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , Transplante de Fígado , RNA Viral/sangue , Quimioterapia Combinada , Feminino , Seguimentos , Genótipo , Sobrevivência de Enxerto , Hepatite C Crônica/sangue , Hepatite C Crônica/mortalidade , Humanos , Interferon-alfa/uso terapêutico , Interferons , Interleucinas/genética , Transplante de Fígado/mortalidade , Quimioterapia de Manutenção/métodos , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Recidiva , Estudos Retrospectivos , Ribavirina/uso terapêutico , Taxa de Sobrevida , Fatores de Tempo
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