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Bitetto D.,University of Udine | De Feo T.,Organ and Tissue Transplantation Immunology | Mantovani M.,Organ and Tissue Transplantation Immunology | Falleti E.,Laboratory Medicine | And 16 more authors.
Digestive and Liver Disease | Year: 2013

Background: The impact of calcineurin inhibitors on achievement of sustained virological response to antiviral therapy for post-transplant recurrent hepatitis C is controversial. This study aimed at investigating the interactions between calcineurin inhibitors and interleukin-28B (IL-28B) gene polymorphisms and sustained virological response. Methods: Retrospective study of 147 liver transplant recipients with recurrent hepatitis C, who received 48 weeks of peg-interferon-α (N=113) or standard interferon (N=34), in association with ribavirin. Cyclosporine and tacrolimus were administered in 68 and 79 patients, respectively. IL-28B rs12979860 allele frequency was assessed in both donors and recipients. Results: Overall, 57 patients (38.8%) obtained sustained virological response; no difference was found between cyclosporine and tacrolimus-treated patients (42.6% vs. 35.4%, p=0.371). Recipient and donor IL-28B genotypic frequencies were C/C=30.6%, C/T=51.7%, T/T=17.7% and C/C=44.9%, C/T=50.3%, T/T=4.8%, respectively. Combining donor and recipient alleles, response rates decreased from cyclosporine-treated patients carrying ≤1 T allele (56.1%) to tacrolimus-treated patients carrying ≤1 T allele (44.7%) to patients carrying ≥2 T alleles (25.0%, p=0.0009). Conclusions: Donor and recipient rs12979860 alleles synergistically influence sustained virological response rate to antiviral treatment for recurrent hepatitis C. In patients carrying <2 T alleles cyclosporine favours a better response than tacrolimus, while no difference was found in the presence of ≥2 T alleles. © 2013 Editrice Gastroenterologica Italiana S.r.l.

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