Antiviral therapy for recurrent hepatitis C after liver transplantation and its effect on liver fibrosis

Objective To perform antiviral therapy in patients with recurrent hepatitis C after liver transplantation and to study the efficacy of antiviral therapy and its effect on the progression of liver fibrosis. Methods Twenty- three patients with recurrent hepatitis C after liver transplantation who were admitted to our hospital from June 2005 to December 2012 were treated with interferon plus ribavirin. Virological response, adverse reactions, and liver pathology were observed before and after treatment. Enumeration data were expressed as number of cases and constituent ratio; comparison of anti- fibrotic effect between the groups with different responses to antiviral therapy was made by rank sum test. Results Twelve patients discontinued treatment due to adverse reactions. Eighteen patients achieved end- of- treatment virological response ( ETVR) ; 6 of the 18 patients achieved sustained virological response ( SVR) , and 12 relapsed after treatment. Nineteen patients underwent liver biopsy before and after treatment. In the SVR group, liver fibrosis was improved in 3 cases, stable in 1 case, and worse in 0 case; in the relapse group, liver fibrosis was improved in 2 cases, stable in 3 cases, and worse in 5 cases; in the patients without response, liver fibrosis was improved in 0 case, stable in 1 case, and worse in 4 cases. There were significant differences in anti- fibrotic effect between the three groups ( χ2= 7. 330, P = 0. 026) . Conclusion SVR rate is low in patients who receive antiviral therapy for recurrent hepatitis C after liver transplantation. Effective antiviral therapy can delay the progression of liver fibrosis, and patients with SVR have the most improvement in liver fibrosis.