Chronic ductopenic rejection in patients with recurrent hepatitis C virus treated with pegylated interferon alfa-2a and ribavirin
Interferon use for post liver transplantation (LT) recurrent hepatitis C (HCV) has not consistently been associated with acute cellular rejection (ACR). We examined the incidence of chronic ductopenic rejection (CR) in patients receiving pegylated interferon alfa-2a and ribavirin (PEG) to treat recu...
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| Veröffentlicht in: | Transplantation 2007-07, Vol.84 (2), p.180-186 |
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| creator | STANCA, Carmen M FIEL, M. Isabel KONTORINIS, Nickolas AGARWAL, Kaushik EMRE, Sukru SCHIANO, Thomas D |
| description | Interferon use for post liver transplantation (LT) recurrent hepatitis C (HCV) has not consistently been associated with acute cellular rejection (ACR). We examined the incidence of chronic ductopenic rejection (CR) in patients receiving pegylated interferon alfa-2a and ribavirin (PEG) to treat recurrent HCV.
A chart review of 12 patients developing CR while receiving an escalating dose regimen of PEG with protocol liver biopsies every 6 months was conducted. Values are shown as median (range).
Twelve of the 70 patients treated with PEG developed CR. Median age at LT was 53 (37-63) years; immunosuppression consisted of tacrolimus or cyclosporine with prednisone. PEG was started at 3.6 (0.2-13.5) years after LT. Two patients had one episode of ACR before PEG. Four patients had first ACR while receiving PEG. CR was diagnosed after 12 (4-17) months of PEG; by then 8 patients had undetectable HCV-RNA. Tacrolimus and cyclosporine levels (ng/mL) were 7.9 (3.2-18.9) and 76 (71-93) before PEG, and 6.9 (3.7-9.7) and 130 (81-153) at CR. Six patients were treated more than 1 year with PEG; three had undetectable HCV-RNA when CR was diagnosed. Five patients are being treated for CR; one has been listed for LT; two patients were retransplanted. Five patients died as a result of sepsis partially related to CR.
Treatment with pegylated-interferon alpha-2a and ribavirin may trigger rapidly progressive CR in patients with therapeutic immunosuppressive trough levels, with or without first inducing ACR. |
| doi_str_mv | 10.1097/01.tp.0000269609.08495.45 |
| format | Article |
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A chart review of 12 patients developing CR while receiving an escalating dose regimen of PEG with protocol liver biopsies every 6 months was conducted. Values are shown as median (range).
Twelve of the 70 patients treated with PEG developed CR. Median age at LT was 53 (37-63) years; immunosuppression consisted of tacrolimus or cyclosporine with prednisone. PEG was started at 3.6 (0.2-13.5) years after LT. Two patients had one episode of ACR before PEG. Four patients had first ACR while receiving PEG. CR was diagnosed after 12 (4-17) months of PEG; by then 8 patients had undetectable HCV-RNA. Tacrolimus and cyclosporine levels (ng/mL) were 7.9 (3.2-18.9) and 76 (71-93) before PEG, and 6.9 (3.7-9.7) and 130 (81-153) at CR. Six patients were treated more than 1 year with PEG; three had undetectable HCV-RNA when CR was diagnosed. Five patients are being treated for CR; one has been listed for LT; two patients were retransplanted. Five patients died as a result of sepsis partially related to CR.
Treatment with pegylated-interferon alpha-2a and ribavirin may trigger rapidly progressive CR in patients with therapeutic immunosuppressive trough levels, with or without first inducing ACR.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/01.tp.0000269609.08495.45</identifier><identifier>PMID: 17667809</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Antiviral Agents - adverse effects ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Biopsy ; Disease Progression ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Rejection - chemically induced ; Graft Rejection - epidemiology ; Graft Rejection - pathology ; Hepacivirus - genetics ; Hepatitis C virus ; Hepatitis C, Chronic - drug therapy ; Hepatitis C, Chronic - mortality ; Hepatitis C, Chronic - surgery ; Human viral diseases ; Humans ; Incidence ; Infectious diseases ; Interferon-alpha - adverse effects ; Interferon-alpha - therapeutic use ; Liver Transplantation ; Male ; Medical sciences ; Middle Aged ; Prognosis ; Recombinant Proteins ; Recurrence ; Ribavirin - adverse effects ; Ribavirin - therapeutic use ; Risk Factors ; RNA, Viral - analysis ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Rate ; Tissue, organ and graft immunology ; Viral diseases ; Viral hepatitis</subject><ispartof>Transplantation, 2007-07, Vol.84 (2), p.180-186</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-98b6b1f32344cff49d9a80f61cd44c84e0c1031d27382fe842cf1b15c55be97a3</citedby><cites>FETCH-LOGICAL-c427t-98b6b1f32344cff49d9a80f61cd44c84e0c1031d27382fe842cf1b15c55be97a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18968210$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17667809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>STANCA, Carmen M</creatorcontrib><creatorcontrib>FIEL, M. Isabel</creatorcontrib><creatorcontrib>KONTORINIS, Nickolas</creatorcontrib><creatorcontrib>AGARWAL, Kaushik</creatorcontrib><creatorcontrib>EMRE, Sukru</creatorcontrib><creatorcontrib>SCHIANO, Thomas D</creatorcontrib><title>Chronic ductopenic rejection in patients with recurrent hepatitis C virus treated with pegylated interferon alfa-2a and ribavirin</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Interferon use for post liver transplantation (LT) recurrent hepatitis C (HCV) has not consistently been associated with acute cellular rejection (ACR). We examined the incidence of chronic ductopenic rejection (CR) in patients receiving pegylated interferon alfa-2a and ribavirin (PEG) to treat recurrent HCV.
A chart review of 12 patients developing CR while receiving an escalating dose regimen of PEG with protocol liver biopsies every 6 months was conducted. Values are shown as median (range).
Twelve of the 70 patients treated with PEG developed CR. Median age at LT was 53 (37-63) years; immunosuppression consisted of tacrolimus or cyclosporine with prednisone. PEG was started at 3.6 (0.2-13.5) years after LT. Two patients had one episode of ACR before PEG. Four patients had first ACR while receiving PEG. CR was diagnosed after 12 (4-17) months of PEG; by then 8 patients had undetectable HCV-RNA. Tacrolimus and cyclosporine levels (ng/mL) were 7.9 (3.2-18.9) and 76 (71-93) before PEG, and 6.9 (3.7-9.7) and 130 (81-153) at CR. Six patients were treated more than 1 year with PEG; three had undetectable HCV-RNA when CR was diagnosed. Five patients are being treated for CR; one has been listed for LT; two patients were retransplanted. Five patients died as a result of sepsis partially related to CR.
Treatment with pegylated-interferon alpha-2a and ribavirin may trigger rapidly progressive CR in patients with therapeutic immunosuppressive trough levels, with or without first inducing ACR.</description><subject>Adult</subject><subject>Antiviral Agents - adverse effects</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Disease Progression</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Rejection - chemically induced</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Rejection - pathology</subject><subject>Hepacivirus - genetics</subject><subject>Hepatitis C virus</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Hepatitis C, Chronic - mortality</subject><subject>Hepatitis C, Chronic - surgery</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infectious diseases</subject><subject>Interferon-alpha - adverse effects</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Recombinant Proteins</subject><subject>Recurrence</subject><subject>Ribavirin - adverse effects</subject><subject>Ribavirin - therapeutic use</subject><subject>Risk Factors</subject><subject>RNA, Viral - analysis</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Rate</subject><subject>Tissue, organ and graft immunology</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEtv3CAURlHVKpmm-QsRXTQ7u7xsYFmN8qgUqZt2jTC-dIg82AHcKsv-8zKZkYYNXO75uOIg9JmSlhItvxLalqUldbFe90S3RAndtaJ7hza046LpiSLv0YYQQRvKubxEH3N-rnzHpbxAl1T2vVREb9C_7S7NMTg8rq7MCxyOCZ7BlTBHHCJebAkQS8Z_Q9nVlltTqjXewaFTQsZb_CekNeOSwBYYj-ACv1-ntzLEAslDnYLt5G3DLLZxxCkMtuZC_IQ-eDtluD7tV-jX_d3P7WPz9OPh-_bbU-MEk6XRaugH6jnjQjjvhR61VcT31I31QgkgjhJORya5Yh6UYM7TgXau6wbQ0vIrdHt8d0nzywq5mH3IDqbJRpjXbBhRWiquK6iPoEtzzgm8WVLY2_RqKDEH_4ZQUxZz9m_e_BvR1ezNacg67GE8J0_CK_DlBNjsqo9kowv5zCndK1Y_8h8L_5GQ</recordid><startdate>20070727</startdate><enddate>20070727</enddate><creator>STANCA, Carmen M</creator><creator>FIEL, M. Isabel</creator><creator>KONTORINIS, Nickolas</creator><creator>AGARWAL, Kaushik</creator><creator>EMRE, Sukru</creator><creator>SCHIANO, Thomas D</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T5</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope></search><sort><creationdate>20070727</creationdate><title>Chronic ductopenic rejection in patients with recurrent hepatitis C virus treated with pegylated interferon alfa-2a and ribavirin</title><author>STANCA, Carmen M ; FIEL, M. Isabel ; KONTORINIS, Nickolas ; AGARWAL, Kaushik ; EMRE, Sukru ; SCHIANO, Thomas D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-98b6b1f32344cff49d9a80f61cd44c84e0c1031d27382fe842cf1b15c55be97a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Antiviral Agents - adverse effects</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Disease Progression</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Rejection - chemically induced</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Rejection - pathology</topic><topic>Hepacivirus - genetics</topic><topic>Hepatitis C virus</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Hepatitis C, Chronic - mortality</topic><topic>Hepatitis C, Chronic - surgery</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infectious diseases</topic><topic>Interferon-alpha - adverse effects</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Recombinant Proteins</topic><topic>Recurrence</topic><topic>Ribavirin - adverse effects</topic><topic>Ribavirin - therapeutic use</topic><topic>Risk Factors</topic><topic>RNA, Viral - analysis</topic><topic>Surgery (general aspects). 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Isabel</creatorcontrib><creatorcontrib>KONTORINIS, Nickolas</creatorcontrib><creatorcontrib>AGARWAL, Kaushik</creatorcontrib><creatorcontrib>EMRE, Sukru</creatorcontrib><creatorcontrib>SCHIANO, Thomas D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STANCA, Carmen M</au><au>FIEL, M. Isabel</au><au>KONTORINIS, Nickolas</au><au>AGARWAL, Kaushik</au><au>EMRE, Sukru</au><au>SCHIANO, Thomas D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic ductopenic rejection in patients with recurrent hepatitis C virus treated with pegylated interferon alfa-2a and ribavirin</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2007-07-27</date><risdate>2007</risdate><volume>84</volume><issue>2</issue><spage>180</spage><epage>186</epage><pages>180-186</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Interferon use for post liver transplantation (LT) recurrent hepatitis C (HCV) has not consistently been associated with acute cellular rejection (ACR). We examined the incidence of chronic ductopenic rejection (CR) in patients receiving pegylated interferon alfa-2a and ribavirin (PEG) to treat recurrent HCV.
A chart review of 12 patients developing CR while receiving an escalating dose regimen of PEG with protocol liver biopsies every 6 months was conducted. Values are shown as median (range).
Twelve of the 70 patients treated with PEG developed CR. Median age at LT was 53 (37-63) years; immunosuppression consisted of tacrolimus or cyclosporine with prednisone. PEG was started at 3.6 (0.2-13.5) years after LT. Two patients had one episode of ACR before PEG. Four patients had first ACR while receiving PEG. CR was diagnosed after 12 (4-17) months of PEG; by then 8 patients had undetectable HCV-RNA. Tacrolimus and cyclosporine levels (ng/mL) were 7.9 (3.2-18.9) and 76 (71-93) before PEG, and 6.9 (3.7-9.7) and 130 (81-153) at CR. Six patients were treated more than 1 year with PEG; three had undetectable HCV-RNA when CR was diagnosed. Five patients are being treated for CR; one has been listed for LT; two patients were retransplanted. Five patients died as a result of sepsis partially related to CR.
Treatment with pegylated-interferon alpha-2a and ribavirin may trigger rapidly progressive CR in patients with therapeutic immunosuppressive trough levels, with or without first inducing ACR.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>17667809</pmid><doi>10.1097/01.tp.0000269609.08495.45</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplantation, 2007-07, Vol.84 (2), p.180-186 |
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| subjects | Adult Antiviral Agents - adverse effects Antiviral Agents - therapeutic use Biological and medical sciences Biopsy Disease Progression Drug Therapy, Combination Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Rejection - chemically induced Graft Rejection - epidemiology Graft Rejection - pathology Hepacivirus - genetics Hepatitis C virus Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - mortality Hepatitis C, Chronic - surgery Human viral diseases Humans Incidence Infectious diseases Interferon-alpha - adverse effects Interferon-alpha - therapeutic use Liver Transplantation Male Medical sciences Middle Aged Prognosis Recombinant Proteins Recurrence Ribavirin - adverse effects Ribavirin - therapeutic use Risk Factors RNA, Viral - analysis Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate Tissue, organ and graft immunology Viral diseases Viral hepatitis |
| title | Chronic ductopenic rejection in patients with recurrent hepatitis C virus treated with pegylated interferon alfa-2a and ribavirin |
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