Treatment of hepatitis C recurrence is less successful in female than in male liver transplant recipients

Authors: Giannelli, Valerio1; Giusto, Michela1; Farcomeni, Alessio2; Ponziani, Francesca R.3; Pompili, Maurizio3; ViganĂ², Raffaella4; Iemmolo, Rosa Maria5; Donato, Maria F.6; Rendina, Maria7; Toniutto, Pierluigi8; Pasulo, Luisa9; Morelli, Maria Cristina10; De Martin, Eleonora11; Miglioresi, Lucia12; Di Paolo, Daniele13; Fagiuoli, Stefano9; Merli, Manuela1; studycr, AISF RECOLT‐C group

Source: Transplant International, Volume 25, Number 4, 1 April 2012 , pp. 448-454(7)

Publisher: Wiley-Blackwell

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Abstract:

Summary

It has been recently suggested that the risk of graft loss after liver transplantation (LT) may increase in female HCV patients. The aim of the study was to examine gender differences in HCV therapy tolerance and outcome in LT patients treated for HCV recurrence. A retrospective study was conducted on liver recipients with HCV recurrence, who were given antiviral therapy from 2001 to 2009 in 12 transplant centers in Italy. Sustained virological response (SVR), adherence‐to‐therapy, and side effects were evaluated. A multivariate logistic regression model was used after adjusting for possible confounders. The data regarding 342 treated patients were analyzed. SVR was reported in 38.8% of patients. At baseline, male and female did not differ in HCV viral load, histology, or rate of diabetes. SVR was lower in females than in males (29.5% vs. 42.1%; P = 0.03). Adherence‐to‐therapy was also lower in females than in males 43.4% vs. 23.8%; P = 0.001); anemia was the main reason for lower adherence. In a multivariate analysis in patients Genotype 1, female gender (P < 0.04), early virological response (P < 0.0001), and adherence to therapy (P < 0.0001) were independent predictors for SVR. In conclusion, female gender represents an independent negative prognostic factor for the outcome of HCV antiviral therapy after LT.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1432-2277.2012.01440.x

Affiliations: 1:  Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy 2:  Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy 3:  Catholic University of the Sacred Heart, Rome, Italy 4:  Ospedale Niguarda, Milano, Italy 5:  University of Modena, Modena, Italy 6:  Ospedale Maggiore, Milan, Italy 7:  University of Bari, Bari, Italy 8:  University of Udine, Udine, Italy 9:  Ospedali Riuniti di Bergamo, Bergamo, Italy 10:  Ospedale S.Orsola-Malpighi, Bologna, Italy 11:  University of Padova, Padova, Italy 12:  Ospedale S.Camillo-Spallanzani, Rome, Italy 13:  Tor Vergata University, Rome, Italy

Publication date: April 1, 2012

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