Long‐term Combination of Interferon Alfa‐2b and Ribavirin for Hepatitis C Recurrence in Liver Transplant Patients

Abstract

The purpose of this study was to evaluate the feasibility, tolerability and efficacy of long‐term combination therapy with interferon‐alfa 2b (IFNα‐2b) and ribavirin (Rb) for recurrent hepatitis C after liver transplantation. Fifteen patients with histologically confirmed hepatitis C after liver transplantation were treated. After a basic course of 12 months (IFNα‐2b 3 MU/3 times a week; Rb 3 × 200 mg/day), patients achieving clearance of viremia underwent maintenance therapy with ribavirin (3 × 200 mg/day). Patients without virological response continuously received combination therapy. Levels of HCV RNA, aminotransferases and bilirubin were followed. Therapy led to a significant decline of transaminases and bilirubin in all patients (p < 0.05). Sixty‐four per cent of patients had clearance of viremia after 12 months. Sustained virological response was 88%. In patients without virological response, continuation of combination therapy prevented another biochemical relapse of hepatitis. Treatment was accompanied by severe hematological side‐effects, requiring medical support in a majority of patients. In two patients (13.5%), therapy finally had to be withdrawn because of major hematological disorders. These results indicate that long‐term combination therapy with IFNα‐2b and Rb is effective in the treatment of recurrent hepatitis C and in preventing further relapse of disease after liver transplantation, but side‐effects may require cessation of therapy.