Almost all patients transplanted for hepatitis C develop recurrent infection in the liver allograft and are at risk of graft fibrosis. The course of hepatitis C after liver transplantation is still unpredictable. Pegylated interferon in combination with Ribavirin is the only hope for treating hepatitis C recurrence with sustained viral response of 27%. Evaluate our experience in treating hepatitis C recurrence after liver transplantation, finding out predictive factors for response to therapy. From December 2006 through June 2008, two liver recipients with recurrent hepatitis C were treated for 48weeks with Pegylated interferon combined with Ribavirin. Baseline quantitative PCR, HCV genotype, and liver enzymes were known for both patients. Prognostic factors for hepatitis C recurrence, and predictor factors for response to therapy were assessed in both patients. Case 1 was transplanted in China from cadaver donor, and case 2 was transplanted in Libya from live donor. Both finished the course of therapy with negative PCR at end of therapy (EOT). Case 1 relapsed after finishing therapy, with histological evidence progressive hepatitis C (A2F2), case 2 had sustained viral response (SVR). Different positive and negative predictive factors for HCV recurrence and response to therapy were evaluated. In conclusion, Factors that may adversely affect outcome of recurrent hepatitis C in liver recipients are; recipient age, genotype 1 or 4, episodes of rejection with multiple steroid pulses, warm ischemia >60 minutes, presence of diabetes mellitus. Delayed treatment, genotype, and inadequate Ribavirin dose are negative predictive factor for response to therapy for recurrent hepatitis C.
Volume : 6
Issue : 4
Pages : 5
Organ Transplantation Program, Central Hospital, Tripoli, Libya