An escalating dose regimen of pegylated interferon and ribavirin in HCV cirrhotic patients referred for liver transplant

Hatef Massoumi, Hussein Elsiesy, Viktoriya Khaitova, Brent Peterson, Edward Norkus, Priya Grewal, Lawrence Liu, Charissa Chang, Nancy Bach, Thomas D. Schiano

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background. To lessen the severity of recurrent hepatitis C virus (HCV) postliver transplantation (post-LT) by treating HCV patients with cirrhosis, we assessed the safety and efficacy of an escalating dose pegylated interferon (PEG-IFN)/ ribavirin protocol in pre-LT patients. Methods. Ninety patients were treated with 90 μg PEG-IFN alpha-2a and 400 mg ribavirin and advanced to 180 μg and 800 to 1200 mg, respectively, over 8 weeks. Results. Mean age was 55.3 years. Thirty-four percent of patients received prior interferon treatment, 77% had genotype 1 or 4. Mean Child's score was 6.7 and model for end-stage liver disease 11.2; 49% reached full-dose PEG-IFN and 85% ribavirin, 18% required dose reduction, 33% stopped treatment because of adverse effects, 9% had deterioration of liver function, and 7% died. Follow-up of 9.6 months showed sustained virological response in 13% of patients. The rate of serious complications was 16.3% in Child's class A, 48% in B, and 100% in C (P=0.005). Serum albumin was a significant predictor for worsening liver function (P=0.007). Conclusions. Using an escalating dose regimen of PEG-IFN alpha-2a and ribavirin, we achieved only a 13% sustained virological response in HCV cirrhotic pre-LT patients with an accompanying 9% risk of worsening liver function and 7% risk of death.

Original languageEnglish
Pages (from-to)729-735
Number of pages7
JournalTransplantation
Volume88
Issue number5
DOIs
StatePublished - 15 Sep 2009

Keywords

  • Hepatitis C
  • Liver transplantation
  • Pegylated interferon

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