Abstract

Background: Hepatitis C recurrence is a common complication after liver
transplantation and leads to liver failure and early graft loss. The aim of our  study was to evaluate effectiveness of treatment with pegylated interferon with ribavirin on virus C eradication. 30 patients with HCV recurrence were followed during the antiviral therapy and 12 months after the end of the treatment. There were 25 patients with HCV genotype 1b, one patient with genotype 3a. 4 patients' genotyping were not done. Before therapy, mean Fibrosis Score was 0.8, and mean Hepatitis Activity Index 6.5. 41% of patients discontinued therapy or have lowered the dose of medications, because of adverse events. By the end of the treatment, HCV negative were 10 patients (34%), after next 12 months HCV negative were only 3 of them (10%) (2 patients with genotype 1b, 1 patient with genotype 3a). Serum virus load was lower at the end of antiviral treatment compared to the pre-therapy load in 11 (60%) patients with persistent viraemia; however at the end of the follow-up virus load was lower only in 8 patients (30%). Liver biopsy (n=9) showed progression of fibrosis or hepatitis in patients which did not eradicate C virus, despite lowering the virus load during the antiviral treatment. In all 4 cases of re-therapy the HCV was not eradicated.
Conclusions: Antiviral treatment of HCV genotype 1b recurrence after liver
transplantation with pegylated interferon and ribavirin gives small percent
of eradication. There is no improvement in histological changes after antiviral treatment in a group of patients without eradication.

Keywords: Liver Transplantation