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Genotype 3 and higher low-density lipoprotein levels are predictors of good response to treatment of recurrent hepatitis C following living donor liver transplantation

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Abstract

Background

Treatment of recurrent hepatitis C after liver transplantation is associated with poor sustained virological response (SVR) in genotype 1, and data on genotype 3 is limited to small numbers. We report one of the largest series of genotype 3 patients treated for recurrent hepatitis C following living donor liver transplantation (LDLT).

Methods

From January 2002 to November 2013, of 1349 transplants, 359 patients had hepatitis C. Patients with histological recurrence were treated with pegylated interferon in escalating dose regimen for 48 weeks and weight-based ribavirin. Virological response was defined as rapid virological response (RVR—4 weeks), early virological response (EVR—12 weeks), end of treatment response (ETR—48 weeks), and SVR (24 weeks after end of treatment). SVR and no-SVR groups were compared for age, sex, body mass index (BMI), diabetes, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, ferritin, genotype, and hepatitis C virus (HCV) RNA levels before initiation of treatment.

Results

The study included 67 patients who had at least 18 months of follow up after treatment initiation (45 males), aged 51 ± 6.3 years. Treatment was started after 16 months (median); baseline median RNA was 2.7 × 106 IU/mL. There was no significant difference between the SVR and no-SVR groups regarding age, sex ratio, follow up period, total cholesterol, triglycerides, HDL, BMI, prevalence of diabetes, HCV RNA, and ferritin levels. Genotype 3, RVR, EVR, ETR, and higher LDL levels were significantly associated with SVR. Genotype 3 had a significantly higher SVR rate of 71 % as compared to an SVR rate of only 14 % in genotype 1, p = 0.0003. Absence of RVR and EVR predicted treatment failure with a specificity of 88 % and 92 %, respectively.

Conclusion

Genotype 3 and higher LDL levels predict SVR in patients treated for hepatitis C recurrence following LDLT, whereas absence of RVR and EVR strongly predict treatment failure.

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Conflict of interest

SS, NSC, NS, DG, LL, AR, SG, PBM, PB, SKR, and ASS declare that they have no competing interests.

Ethics statement

The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Authors and Affiliations

  1. Medanta Liver Institute, Gurgaon, Haryana, 122 001, India

    Sanjiv Saigal, Narendra S. Choudhary, Neeraj Saraf, Amit Rastogi, Sanjay Goja, P. Balachandran Menon, Prashant Bhangui, Sumana K. Ramachandra & Arvinder S. Soin

  2. Department of Histopathology, Medanta The Medicity, Gurgaon, Haryana, 122 001, India

    Dheeraj Gautam & Lipika Lipi

Authors
  1. Sanjiv Saigal
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  2. Narendra S. Choudhary
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  11. Arvinder S. Soin
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Correspondence to Sanjiv Saigal.

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Saigal, S., Choudhary, N.S., Saraf, N. et al. Genotype 3 and higher low-density lipoprotein levels are predictors of good response to treatment of recurrent hepatitis C following living donor liver transplantation. Indian J Gastroenterol 34, 305–309 (2015). https://doi.org/10.1007/s12664-015-0578-z

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  • DOI: https://doi.org/10.1007/s12664-015-0578-z

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