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Telaprevir With Peginterferon/Ribavirin For Retreatment Of Null Responders With Advanced Fibrosis Post Orthotopic Liver Transplant.
MedLine Citation:
PMID:  24708229     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aggressive recurrence of hepatitis C remains problematic post OLT. There are limited data on treatment of HCV infection with telaprevir/boceprevir therapy with peginterferon/ribavirin (PR) post OLT. AIM To review our experience with telaprevir addition to peginterferon/ribavirin in treatment of aggressive hepatitis C in null responders to PR post OLT. Methods: Adult patients with recurrent HCV infection post OLT with null response to peginterferon/ribavirin for 12 weeks (< 2 log reduction) received 4 week lead-in PEG-IFN alfa-2b (1.0 μg/kg/wk) plus RBV (600-1000 mg/day) followed by addition of telaprevir 750 q8. All patients were converted to cyclosporine from tacrolimus. Results: Seven patients (3 M, 4 F), mean age 56 years, were treated. 3 were < 1 year post-OLT, 6 had cirrhosis/1 bridging fibrosis. Three of 7 achieved SVR. All patients required RBV dose reduction, 6/7 required EPO, 5/7 required filgrastim, 2/7 required eltrombopog for platelets <20,000 μl. There were no supra/sub-therapeutic CYA levels encountered, no episodes of renal insufficiency. Conclusions. Conversion to cyclosporine followed by four week peginterferon/ribavirin lead-in with addition of telaprevir can lead to significant clearance rates at week 24 in null responders with advanced fibrosis though high rates of anemia/RBV dose reduction, growth factor, and transfusion requirements were noted. This article is protected by copyright. All rights reserved.
Authors:
Paul Y Kwo; Marwan Ghabril; Marco A Lacerda; A Joseph Tector; Jonathan A Fridell; Rodrigo Vianna
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-8
Journal Detail:
Title:  Clinical transplantation     Volume:  -     ISSN:  1399-0012     ISO Abbreviation:  Clin Transplant     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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