Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation. [artículo]
Por: Abradelo de Usera, Manuel [Cirugía General y Aparato Digestivo]
| Aguado García, José María [Enfermedades Infecciosas] | Colina Ruiz-Delgado, Francisco [Anatomía Patológica] | Fernández Vázquez, Inmaculada [Aparato Digestivo] | Fuertes Ortiz de Urbina, Antonio [Microbiología y Parasitología] | García Reyne, Ana [Medicina Interna] | Lizasoaín Hernández, Manuel [Medicina Interna] | López Medrano, Francisco [Enfermedades Infecciosas] | Lumbreras Bermejo, Carlos [Medicina Interna] | Magán Tapia, Purificación [Instituto de Investigación i+12] | Manrique Municio, Alejandro [Cirugía General y del Aparato Digestivo] | Moreno González, Enrique [Cirugía General y del Aparato Digestivo] | San Juan Garrido, Rafael [Medicina Interna].
Colaborador(es): Servicio de Anatomía Patológica | Servicio de Cirugía General y del Aparato Digestivo | Servicio de Medicina Interna | Servicio de Microbiología y Parasitología | Instituto de Investigación imas12 | Servicio de Medicina del Aparato Digestivo.
Editor: Transplant infectious disease: an official journal of the Transplantation Society, 2013Descripción: 15(4):405-15.Recursos en línea: Solicitar documento Resumen: 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.
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Artículo
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PC8414 (Navegar estantería) | Disponible |
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.
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