Treatment of Established Recurrent Hepatitis C in Liver-Transplant Recipients with Pegylated Interferon-alfa-2b and Ribavirin Therapy
Treatment of Established Recurrent Hepatitis C in Liver-Transplant Recipients with Pegylated Interferon-alfa-2b and Ribavirin Therapy
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用聚乙二醇化干扰素-α-2b 和利巴韦林疗法治疗肝移植受者中已确诊的复发性丙型肝炎
DOI：
10.1097/01.tp.0000129811.93072.1c
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发表时间：
2004
期刊：
影响因子：
6.2
通讯作者：
E. Schiff
中科院分区：
文献类型：
--
作者：
G. Neff;M. Montalbano;C. O’Brien;S. Nishida;K. Safdar;P. Bejarano;A. Khaled;P. Ruiz;G. Slapak;M. Lee;J. Nery;M. de Medina;A. Tzakis;E. Schiff
导论.丙型肝炎病毒（HCV）移植患者的管理问题很复杂，干扰素治疗往往无效。我们提供的数据来自于一项回顾性研究，该研究对接受聚乙二醇化α-2b干扰素和利巴韦林治疗的HCV复发的肝移植受者进行了回顾性研究。方法.对接受聚乙二醇化α-2b干扰素（1.5 mcg/kg/周）和利巴韦林（400-600 mg/天）联合治疗至少48周的移植受者进行回顾性分析。记录并发症，包括中性粒细胞减少症（<750个细胞）、贫血（血红蛋白<8 g）（有或无输血、促红细胞生成素或利巴韦林剂量减少）和抑郁症。HCV复发的诊断是通过使用COBAS AMPLY COR HCV检测的肝脏化学成分增加、炎症组织病理学结果沿着病毒复发来确定的。结果纳入57例肝移植受者，其中29例为初治受者（第1组），28例为干扰素和利巴韦林治疗至少6个月后无应答者（第2组）。在48周治疗结束时，第1组中有8例（27.6%）患者和第2组中有6例（21%）患者未检出HCV。第1组29例患者中有13例（45%）利巴韦林治疗减少，第2组28例患者中有11例（39%）利巴韦林治疗减少。治疗干预包括4/57例（7%）输血，23/57例（40%）促红细胞生成素，17/57例（30%）非格司亭。结论聚乙二醇干扰素联合利巴韦林似乎是治疗HCV复发和对干扰素和利巴韦林无反应的HCV的有效方法。这些数据揭示了在用聚乙二醇化α-2b干扰素和利巴韦林联合治疗HCV-R肝移植受者时必须采取的困难和谨慎。
Introduction. The management issues of transplant patients with hepatitis C virus (HCV) are complex, and interferon therapy is often ineffective. We present data from a retrospective review in liver-transplant recipients suffering from HCV recurrence that were treated with pegylated alpha-2b interferon and ribavirin. Methods. A retrospective review of transplant recipients that received combination pegylated alpha-2b interferon (1.5 mcg/kg/wk) and ribavirin (400–600 mg/day) therapy intended for at least 48 weeks. Complications were recorded and included neutropenia (<750 cells), anemia (hemoglobin <8 g) with and without treatment consisting of blood transfusions, erythropoietin, or dose reduction of ribavirin, and depression. The diagnosis of HCV recurrence was determined by an increase in liver chemistries, histopathologic findings with inflammation along with viral recurrence using the COBAS AMPLICOR HCV test. Results. Fifty-seven liver-transplant recipients were included, 29 naïve (group 1) to therapy and 28 nonresponders (group 2) to at least 6 months of interferon and ribavirin therapy. Eight (27.6%) patients in group 1 and six (21%) patients in group 2 were HCV nondetectable at the end of 48 weeks of therapy. Ribavirin therapy was decreased in 13 of 29 (45%) for group 1 and 11 of 28 (39%) in group 2. Therapeutic interventions were 4 of 57 (7%) blood transfusions, 23 of 57 (40%) erythropoietin, and 17 of 57 (30%) filgrastim. Conclusion. Combination pegylated interferon with ribavirin appears to effective therapy in HCV recurrence and in HCV nonresponsive to interferon and ribavirin. This data reveals the difficulty and caution that must be taken when treating HCV-R liver-transplant recipients with combination pegylated alpha-2b interferon and ribavirin therapy.
影响因子：
29.4
作者：
McHutchison, JG;Manns, M;Albrecht, JK
通讯作者：
Albrecht, JK