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. 2013;8(3):e58380.
doi: 10.1371/journal.pone.0058380. Epub 2013 Mar 7.

Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation

Yoshihide Ueda  1 , Toshimi Kaido, Yasuhiro Ogura, Kohei Ogawa, Atsushi Yoshizawa, Koichiro Hata, Yasuhiro Fujimoto, Aya Miyagawa-Hayashino, Hironori Haga, Hiroyuki Marusawa, Satoshi Teramukai, Shinji Uemoto, Tsutomu Chiba
Affiliations

Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation

Yoshihide Ueda et al. PLoS One. 2013.

Erratum in

  • PLoS One. 2013;8(11). doi:10.1371/annotation/1601274b-def0-4970-8e61-62e657c2d1ae

Abstract

Background: Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events.

Methods: A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011.

Results: Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables-pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype-remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found.

Conclusions: Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy.

Trial registration: UMIN-CTR UMIN000003286.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram showing the outcome of interferon therapy in patients with recurrent hepatitis C after living donor liver transplantation (LDLT) and indicating the classification of patients in this study.
N, number of patients; VR, virological response; SVR, sustained virological response; NR, nonresponder.
See this image and copyright information in PMC

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