Study determines long-term clinical outcome of patients posttransplant after anitviral therapy

Researchers from the University of Bari, Italy, concluded that treating patients after transplantation with antiviral therapy creates a sustained viral response (SVR) and protects them from liver-related deaths. The purpose of this study was to determine the long-term clinical outcomes of patients posttransplant who underwent antiviral therapy for recurrent hepatitis C virus (HCV) infection of the liver graft.

The use in clinical practice of antiviral therapy for HCV recurrence after liver transplantation is still controversial. Some favor antiviral therapy while data coming from meta-analysis of published studies do not recommend treatment in view of the frequent adverse effects and the lack of clinical benefit.

Maria Rendina, MD, on behalf of the AISF RECOLT-C Group, examined the records from 12 liver transplant centers in Italy over a 20-year period, and showed data on SVR and long-term clinical outcomes for a large posttransplantation patient population.

SVR was achieved in 35 percent of the 448 patients whose records were included in this study. Researchers noted that patients who achieved SVR received grafts from younger donors, received longer treatment duration and cumulative dose of interferon, and had a lower drop-out rate and lower incidence of diabetes; however there were no differences in immunosuppressive strategy for these patients.

Of the 134 patients who died since transplantation, 73 percent of those deaths were HCV related – and only one of those patients was able to achieve SVR. After univariate and multivariate analysis to correct for other variables, researchers demonstrated that patients with recurrent HCV who were unable to achieve SVR were at a high risk for liver-related deaths.  

According to Dr. Rendina: "The results of the study are important as these data could have an impact on patient care: HCV viral eradication significantly protects patients from liver-related death and, therefore, must be strongly pursued. When asked about the future of research in this area, Dr. Rendina said, "Data from the AISF RECOLT-C Group provide a direction for further randomized clinical trials aimed at exploring various treatment options as well as the efficacy of new antivirals."