Hepatitis C in Liver Allograft Recipients: Utility of One-Year Post-Transplantation Biopsy as an Indicator of Antiviral Therapy.
Publication/Presentation Date
12-1-2015
Abstract
BACKGROUND: All-oral interferon-free regimens for hepatitis C viral (HCV) infection are highly efficacious; however, high cost is a barrier to applicability. Liver allograft recipients are particularly likely to benefit from therapy as HCV often leads to graft dysfunction and loss. In this study, we aimed to establish the utility of allograft biopsy at 1 year post-transplant as an indicator of treatment.
METHODS AND RESULTS: Among 252 liver recipients enrolled, 136 (54%) developed severe disease (fibrosing cholestatic hepatitis (FCH) or fibrosis stage ≥ 2 at 1 year post-transplant). Multivariable analysis revealed younger recipient age and female gender, older donor age and T cell depletive therapy to be independent predictors of severe disease. Recipients with severe disease had higher rate of further graft loss compared to those with mild disease. Patients with mild disease and sustained virologic response (SVR) had the best survival rate, whereas those with severe disease and viremia had the worst survival (96% versus 63% at 5 years).
CONCLUSION: In conclusion, allograft biopsy at 1 year helps identify recipients at high risk of further graft dysfunction and loss. In view of high cost of therapy, treatment should be preferably directed to high-risk patients including those with FCH or fibrosis stage ≥ 2 by 1 year post-transplant.
Volume
8
Issue
6
First Page
281
Last Page
290
ISSN
1918-2805
Published In/Presented At
Habib, S., Malik, S., Fu, B., Chang, J., Nalesnik, M., Humar, A., & Shaikh, O. S. (2015). Hepatitis C in Liver Allograft Recipients: Utility of One-Year Post-Transplantation Biopsy as an Indicator of Antiviral Therapy. Gastroenterology research, 8(6), 281–290. https://doi.org/10.14740/gr694w
Disciplines
Medicine and Health Sciences
PubMedID
27785310
Department(s)
Department of Medicine
Document Type
Article
