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Histopathologic efficacy of ribavirin monotherapy in kidney allograft recipients with chronic hepatitis C

Histopathologic efficacy of ribavirin monotherapy in kidney allograft recipients with chronic hepatitis C

Authors :
Bertrand Nalpas
Pascal Lebray
Hélène Fontaine
Stanislas Pol
Jean Serpaggi
Claudia Equi-Andrade
Henri Kreis
Anaïs Vallet-Pichard
Rodalphe Sobesky
Virginia Verkarre
Marie-Laure Chaix
Source :
Transplantation. 78(6)
Publication Year :
2004

Abstract

BACKGROUND The deterioration of chronic hepatitis C is frequent in kidney recipients and results in a decrease in survival of patients and allografts. Interferon is contraindicated because of the risk of rejection and its low efficacy. The aim of this study was to analyze the biologic, virologic, and histopathologic efficacy of ribavirin alone in kidney allograft recipients with hepatitis C. METHODS Thirteen kidney recipients (eight men and five women, 46+/-11 years of age) with severe Metavir score of fibrosis (eight F3 and five F4) were treated with ribavirin alone during 22.4+/-13.9 months. Liver biopsy was performed before and during therapy, with a mean interval time of 5.7+/-9.3 years. RESULTS The transaminase level decreased significantly (128+/-77 vs. 53+/-28, P=0.001) without significant change of serum quantitative hepatitis C virus load. The comparison of pretreatment and on-treatment biopsy specimens showed a significant decrease in the activity Metavir score (1.23+/-1.01 vs. 2.46+/-0.78, P=0.05) and a nonsignificant trend for a decrease in the fibrosis score. Ribavirin tolerance was fair, and only one patient required erythropoietin therapy. CONCLUSIONS Ribavirin alone in kidney allograft recipients results in biologic and histologic improvement without a virologic response and is reasonably well tolerated.

Details

ISSN :
00411337
Volume :
78
Issue :
6
Database :
OpenAIRE
Journal :
Transplantation
Accession number :
edsair.doi.dedup.....896a4b5a15d4cd6dca0d4eb36de1d23b