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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Aug 21, 2014; 20(31): 10668-10681
Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10668
Table 1 Treatment of hepatitis C virus cirrhosis with interferon and ribavirin
RefnChild scoreTreatmentMean treatment duration (mo)End of treatment response/post-LT SVR
Everson et al[1]1247IFN and RBV6-1246%/30%
Carrion et al[2]5188% A or BPEG-IFN and RBV329%/20%
Everson et al[3]637PEG-IFN and RBV459%/25%
Table 2 Treatment of hepatitis C cirrhosis with triple therapy
Fibrosis stageDrugPrior PEG-IFN responsiveness (n)Treatment responseSerious adverse events1Ref.
CirrhosisTelaprevir2162% SVR9%[4]
Bridging fibrosis and cirrhosisBoceprevir7647% SVR12%[5]
Relapse (n = 119)85% SVR
Partial response (n = 50)42% SVR
Null response (n = 88)24% SVR
Bridging fibrosis and cirrhosisBoceprevirRelapse and partial response (n = 63)56% SVR12%[7]
Child ATelaprevir28567% (16 wk)45%[8]
Boceprevir20458% (16 wk)33%
Table 3 Risk factors studied for association with more severe hepatitis C virus recurrence
FactorEvidence
Donor
Age > 40 yr↑↑↑
Living donor
Split liver
DCD
HCV+
Macrovesicular steatosis > 30%↑↓
IRI↑↓
IL28B “CC” genotype↑↓
Virus
HCV genotype 1
High pre-transplant HCV RNA
HCV RNA 4 mo post LT ≥ 1 × 109 mEq/mL↑↑
CMV viremia↑↑↑
HIV coinfection↑↑
Recipient
Female sex↑↑
African American D/R mismatch↑↑
African American D/R match
Metabolic syndrome1
IL28B non-“CC” genotype
Immunosuppression
Pulsed corticosteroids for American College of Rheumatology↑↑↑
Tacrolimus (vs CsA)↑↓
Sirolimus
Thymoglobulin
Basiliximab
OKT3
Table 4 Liver biopsy findings in recurrent hepatitis C and acute cellular rejection
Favors hepatitis CFavors rejection
Apoptotic (Councilman) bodiesCentral venulitis
Lymphoid aggregatesPerivenular necrosis
Kupffer cell hypertrophyInflammatory bile duct damage
Mononuclear portal inflammationBiliary epithelial senescence changes
Ballooning degeneration