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Peg-IFN and ribavir...
Peg-IFN and ribavirin treatment for recurrence of genotype 2 and 3 hepatitis C after liver transplantation
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- Ackefors, M. (författare)
- Karolinska University Hospital
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- Castedal, Maria, 1964 (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Dahlgard, O. (författare)
- Oslo university hospital
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- Verbaan, Hans (författare)
- Lund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups
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- Gjertsen, H. (författare)
- Karolinska Institutet
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- Wernerson, A. (författare)
- Karolinska Institutet
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- Weiland, O. (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2015-02-04
- 2015
- Engelska.
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 47:4, s. 209-217
- Relaterad länk:
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http://dx.doi.org/10...
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https://gup.ub.gu.se...
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https://doi.org/10.3...
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https://lup.lub.lu.s...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: Relapse of hepatitis C virus (HCV) infection after liver transplantation (LT) is universal. Tolerance for treatment with pegylated-interferon (peg-IFN) and ribavirin (RBV) is suboptimal and withdrawals due to adverse events frequent. We sought to improve tolerance for treatment to improve outcome. Methods: We used concentration-guided RBV dosing to achieve an intended 10 mu mol/L concentration with darbepoetin support in combination with peg-IFN alfa-2a, 180 mu g for genotype 1 and 135 mu g for genotype 2/3 to improve tolerance. Results: A total of 51/54 patients (94%) completed a full treatment course. In the per-protocol analysis 43% of patients (22/51) achieved sustained virological response (SVR), 82% with HCV genotype 2/3 and 22% with genotype 1, p = 0.0001. Patients with IL28B CC achieved SVR in 73% (8/11) and patients with non-CC in 33% (14/43), p = 0.016. Patients with mild fi brosis (fi brosis stage 1-2) achieved SVR in 56% (15/27), and patients with advanced fi brosis (fi brosis stage 3 -4) in only 26% (7/27), p = 0.0267. Conclusions: Concentration-guided RBV dosing with darbepoetin support substantially improves tolerance and offers high adherence to a full peg-IFN and RBV treatment course in patients with post-transplant HCV relapse. With this approach genotype 2 and 3 infections can be treated cost-effectively post-transplant. Genotype 1, IL28B non-CC genotype, and advanced fi brosis predicted a low SVR rate.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- HCV
- peg-IFN
- ribavirin
- liver transplantation
- chronic HCV
- ALPHA-2B PLUS RIBAVIRIN
- PEGYLATED INTERFERON
- COMBINATION THERAPY
- ANTIVIRAL THERAPY
- INITIAL TREATMENT
- VIRUS-INFECTION
- SOFOSBUVIR
- RECIPIENTS
- CIRRHOSIS
- STANDARD
- Infectious Diseases
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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