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Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection.

Publication ,  Journal Article
Kuo, A; Tan, V; Lan, B; Khalili, M; Feng, S; Roberts, JP; Terrault, NA
Published in: Liver Transpl
October 2008

The long-term effects of preemptive antiviral therapy on fibrosis progression in liver transplant recipients with hepatitis C virus (HCV) were examined in a cohort of consecutive liver transplant recipients who received preemptive antiviral therapy for 48 weeks (95% were virologic nonresponders). Control patients were transplanted during this same period but did not receive preemptive therapy. Patients were followed to the date of last biopsy and censored at the time of subsequent HCV treatment. Eighty-six patients surviving >/=90 days were included. Treated and control patients were similar, except that treated patients had longer histological follow-up (60 versus 50 months), a lower median Model for End-Stage Liver Disease score at liver transplant (17 versus 23), and a shorter median length of hospital stay (6 versus 9.5 days). In the uncensored analysis, the cumulative probability of a Batts-Ludwig fibrosis score >/= 2 at 48 months post-liver transplant was 22% in the preemptive therapy group and 49% in the nonpreemptive therapy group (P = 0.08). In multivariate analysis, preemptive therapy was associated with a 48% reduced risk of a fibrosis score >/= 2 (hazard ratio = 0.52, 95% confidence interval = 0.24-1.12, P = 0.09), but this failed to achieve statistical significance. Receipt of preemptive therapy was associated with a delay in subsequent HCV therapy for moderate to severe disease (fibrosis score >/= 2 or moderate necroinflammatory activity) with a median time of 36.3 months versus 20.3 months in the preemptive and nonpreemptive groups (P = 0.004). We conclude that preemptive antiviral therapy in virologic nonresponders delays the time to subsequent HCV treatment and may confer a reduced risk of fibrosis progression. Further study of preemptive antiviral therapy is warranted.

Duke Scholars

Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

October 2008

Volume

14

Issue

10

Start / End Page

1491 / 1497

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Secondary Prevention
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Middle Aged
  • Male
  • Liver Transplantation
  • Liver Cirrhosis
  • Liver
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kuo, A., Tan, V., Lan, B., Khalili, M., Feng, S., Roberts, J. P., & Terrault, N. A. (2008). Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection. Liver Transpl, 14(10), 1491–1497. https://doi.org/10.1002/lt.21548
Kuo, Alexander, Vivian Tan, Billy Lan, Mandana Khalili, Sandy Feng, John P. Roberts, and Norah A. Terrault. “Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection.Liver Transpl 14, no. 10 (October 2008): 1491–97. https://doi.org/10.1002/lt.21548.
Kuo A, Tan V, Lan B, Khalili M, Feng S, Roberts JP, et al. Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection. Liver Transpl. 2008 Oct;14(10):1491–7.
Kuo, Alexander, et al. “Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection.Liver Transpl, vol. 14, no. 10, Oct. 2008, pp. 1491–97. Pubmed, doi:10.1002/lt.21548.
Kuo A, Tan V, Lan B, Khalili M, Feng S, Roberts JP, Terrault NA. Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection. Liver Transpl. 2008 Oct;14(10):1491–1497.
Journal cover image

Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

October 2008

Volume

14

Issue

10

Start / End Page

1491 / 1497

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Secondary Prevention
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Middle Aged
  • Male
  • Liver Transplantation
  • Liver Cirrhosis
  • Liver