Abradelo de Usera, Manuel Aguado García, José María Colina Ruiz-Delgado, Francisco Fernández Vázquez, Inmaculada Fuertes Ortiz de Urbina, Antonio García Reyne, Ana Lizasoaín Hernández, Manuel López Medrano, Francisco Lumbreras Bermejo, Carlos Magán Tapia, Purificación Manrique Municio, Alejandro Moreno González, Enrique San Juan Garrido, Rafael
Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation. [artículo] - Transplant infectious disease: an official journal of the Transplantation Society, 2013 - 15(4):405-15.
Formato Vancouver:
García-Reyne A, Lumbreras C, Fernández I, Colina F, Abradelo M, Magan P et al. Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation. Transpl Infect Dis.
2013 Aug;15(4):405-15.
PMID: 23725370
Contiene 41 referencias
INTRODUCTION: Severity of recurrent hepatitis C virus (HCV) infection in liver transplant recipients (LTR) is variable and the influence of different factors, including the administration of antiviral therapy in the long-term outcome is controversial. METHODS: We analyzed the outcome of a cohort of HCV-infected LTR who were transplanted in our institution. Patients were divided into 2 groups (severe and non-severe HCV disease) depending on the presence of a fibrosis score of F ≥2 in the Scheuer index and/or fibrosing cholestasic hepatitis (FCH) in a graft biopsy. Risk factors were studied using logistic regression analysis. Survival of patients was estimated using Kaplan-Meier plots. A total of 146 patients were followed for a mean of 58 months. RESULTS: Fifty-six (34%) patients developed severe HCV disease and showed shorter survival (P < 0.024). Donor age (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.02-1.06) and pre-transplant viral load (VL) >10(6) UI/mL (OR: 3.5; 95% CI: 1.42-10.61) were the only factors associated with severe HCV infection. Over-immunosuppression (OR: 2.3; 95% CI: 1.2-4.41) was specifically associated with the development of FCH. Overall, patient survival in recipients who received a full course of anti-HCV therapy was higher than in patients who did not complete antiviral therapy (P = 0.004) or received no treatment (P = 0.007). Patients with non-severe HCV infection have a higher probability of receiving a full course of antiviral therapy (P = 0.033). CONCLUSION: In conclusion, donor age, pre-transplant VL, and over-immunosuppression were associated with the long-term development of severe HCV recurrence in liver grafts. Administration of a full course of antiviral therapy was associated with better survival.
Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation. [artículo] - Transplant infectious disease: an official journal of the Transplantation Society, 2013 - 15(4):405-15.
Formato Vancouver:
García-Reyne A, Lumbreras C, Fernández I, Colina F, Abradelo M, Magan P et al. Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation. Transpl Infect Dis.
2013 Aug;15(4):405-15.
PMID: 23725370
Contiene 41 referencias
INTRODUCTION: Severity of recurrent hepatitis C virus (HCV) infection in liver transplant recipients (LTR) is variable and the influence of different factors, including the administration of antiviral therapy in the long-term outcome is controversial. METHODS: We analyzed the outcome of a cohort of HCV-infected LTR who were transplanted in our institution. Patients were divided into 2 groups (severe and non-severe HCV disease) depending on the presence of a fibrosis score of F ≥2 in the Scheuer index and/or fibrosing cholestasic hepatitis (FCH) in a graft biopsy. Risk factors were studied using logistic regression analysis. Survival of patients was estimated using Kaplan-Meier plots. A total of 146 patients were followed for a mean of 58 months. RESULTS: Fifty-six (34%) patients developed severe HCV disease and showed shorter survival (P < 0.024). Donor age (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.02-1.06) and pre-transplant viral load (VL) >10(6) UI/mL (OR: 3.5; 95% CI: 1.42-10.61) were the only factors associated with severe HCV infection. Over-immunosuppression (OR: 2.3; 95% CI: 1.2-4.41) was specifically associated with the development of FCH. Overall, patient survival in recipients who received a full course of anti-HCV therapy was higher than in patients who did not complete antiviral therapy (P = 0.004) or received no treatment (P = 0.007). Patients with non-severe HCV infection have a higher probability of receiving a full course of antiviral therapy (P = 0.033). CONCLUSION: In conclusion, donor age, pre-transplant VL, and over-immunosuppression were associated with the long-term development of severe HCV recurrence in liver grafts. Administration of a full course of antiviral therapy was associated with better survival.
