trying... 5101MCID_676f086b24a67d5c5b0ec6c415996238Thierry Bizollon[author]Bizollon, Thierry[Full Author Name]bizollon, thierry[Author]
trying2... trying... 1599623820051004202301241600-6135582005AugAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant SurgeonsAm J TransplantBenefit of sustained virological response to combination therapy on graft survival of liver transplanted patients with recurrent chronic hepatitis C.190919131909-13Recurrent hepatitis C infection is an important cause of progressive fibrosis, cirrhosis and graft loss after liver transplantation. Treatment for post-transplant recurrence results in sustained virological response (SVR) in up to 30% of cases. The aim of this study was to evaluate the impact of SVR on patients and graft survival. Thirty-four patients with an SVR to IFN-ribavirin were included. Forty-six nonresponders to the combination formed the control group. Follow-up data were recorded every 6 months and included HCV RNA, and the occurrence of clinical problems (cirrhosis, decompensation, hepatocellular carcinoma, death). A graft biopsy was performed every year. The mean follow-up duration was 52 months in responders and 57 months in nonresponders. Two patients died in each group of patients. Two patients with SVR developed late virological relapse. Fibrosis decreased in 38% of patients with SVR, remained stable in 44% and worsened in 18%. In contrast, fibrosis increased in the majority of nonresponder patients (74%, p<0.001). At the end of follow-up, no patient without cirrhosis at inclusion developed cirrhosis of the graft versus 9 among nonresponder patients (p=0.009). No difference in patient survival was observed in the two groups. In conclusion, this study shows that HCV eradication has a positive impact on graft survival.BizollonThierryTHôtel-Dieu, Lyon, France. thierry.bizollon@chu-lyon.frPradatPierrePMabrutJean-YvesJYChevallierMichelleMAdhamMustaphaMRadenneSylvieSSouquetJean-ChristopheJCDucerfChristianCBaulieuxJacquesJZoulimFabienFTrepoChristianCengJournal ArticleUnited StatesAm J Transplant1009686381600-61350Antiviral Agents0RNA, Viral49717AWG6KRibavirin9008-11-1InterferonsIMAdultAgedAntiviral Agentstherapeutic useCarcinoma, HepatocellularetiologyDrug Therapy, CombinationFemaleGraft SurvivalphysiologyHepacivirusdrug effectsHepatitis C, Chronicdrug therapyHumansInterferonstherapeutic useLiverpathologyLiver CirrhosisetiologyLiver NeoplasmsetiologyLiver TransplantationMaleMiddle AgedRNA, ViralanalysisRecurrenceRibavirintherapeutic useTreatment OutcomeViral Load2005769020051059020057690ppublish1599623810.1111/j.1600-6143.2005.00976.xS1600-6135(22)12681-X1569976320050322201907130041-13377932005Feb15TransplantationTransplantationTriple antiviral therapy with amantadine for IFN-ribavirin nonresponders with recurrent posttransplantation hepatitis C.325329325-9HCV reinfection after liver transplantation is universal and has an accelerated course with a high risk of progression to cirrhosis. It is now established that combination therapy with interferon (IFN) alpha and ribavirin may achieve a sustained virological response in 20% of transplanted patients. However, the optimal therapy for nonresponders remains an unresolved issue. We conducted a pilot study to determine the efficacy and safety of triple antiviral therapy in IFN-ribavirin nonresponders with recurrent chronic hepatitis C.Twenty-four nonresponders to the IFN-ribavirin combination were enrolled in this pilot study. Patients were treated with IFN-alpha (3 million units three times a week subcutaneously with ribavirin [800-1,000 mg daily]) and amantadine 200 mg daily for 48 weeks. The primary end point was the loss of HCV RNA 6 months after the end of treatment.Median age was 50 years; 72% were men and 82% had genotype 1. The median interval between the end of combination therapy and enrollment was 11 months. Twenty-four patients started therapy, but five (21%) withdrew due to side effects, including two with anemia. On an intent-to-treat basis, 18 patients (75%) had a biochemical response and 9 (37%) had a virologic response at the end of triple antiviral therapy. Eight of these nine patients (33%) had a sustained virological response. The mean METAVIR score improved from A 2.2 F2.1 before treatment to A 1.2 F1.9 in sustained virological responders. In virological nonresponders, inflammatory activity did not change, but fibrosis worsened. Several patients required treatment with erythropoietin for anemia. Triple therapy was well tolerated and neither increased the frequency nor severity of side effects.Our results show that triple antiviral therapy for 48 weeks induced a sustained virological response in 33% of IFN-ribavirin nonresponders with recurrent hepatitis C.BizollonThierryTHôtel-Dieu 1, Lyon, France. thierry.bizollon@chu-lyon.frAdhamMustaphaMPradatPierrePChevallierMichelleMDucerfChristianCBaulieuxJacquesJZoulimFabianFTrepoChristianCengClinical TrialJournal ArticleUnited StatesTransplantation01321440041-13370Antiviral Agents0Immunosuppressive Agents0Interferon alpha-20Interferon-alpha0RNA, Viral0Recombinant Proteins49717AWG6KRibavirinBF4C9Z1J53AmantadineIMAdultAmantadinetherapeutic useAntiviral Agentstherapeutic useBlood Cell CountDrug Therapy, CombinationFemaleHepacivirusisolation & purificationHepatitis Cdrug therapysurgeryHumansImmunosuppressive Agentstherapeutic useInterferon alpha-2Interferon-alphatherapeutic useLiver TransplantationmortalityMaleMiddle AgedPostoperative Complicationsprevention & controlvirologyRNA, ViralbloodRecombinant ProteinsRecurrenceRibavirintherapeutic useSurvival Analysis2005299020053239020052990ppublish1569976310.1097/01.tp.0000149499.78996.b300007890-200502150-000101261290320030327202203210016-508512432003MarGastroenterologyGastroenterologyInterferon-alpha 2b plus ribavirin in patients with chronic hepatitis C after liver transplantation: a randomized study.642650642-50Hepatitis C virus (HCV) reinfection after liver transplantation is frequent and leads to chronic hepatitis and cirrhosis. The use of antiviral therapy in this situation remains controversial. This study aimed to assess the safety and efficacy of interferon alfa-2b plus ribavirin for recurrent hepatitis C following liver transplantation.Transplant recipients with recurrent chronic hepatitis C were randomized to receive either no treatment or therapy with interferon alfa-2b (3 MU 3 times a week) plus 1000-1200 mg/day ribavirin for 1 year. Patients were followed up for 6 months after the end of treatment. The primary end point was loss of HCV RNA 6 months after the end of treatment.Fifty-two patients were randomized (treatment, 28; placebo, 24). Sixteen patients were withdrawn from the study; 12 (43%) were from the treated group (mainly for anemia [7 patients]) and 4 (17%) from the control group. In the treated group, serum HCV RNA was undetectable in 9 patients (32%) at the end of treatment and 6 (21.4%) at the end of the follow-up period, whereas no patient in the control group lost HCV RNA at any point (P = 0.036 at the end of follow-up). However, there was no significant histologic improvement.The combination of interferon alfa-2b plus ribavirin induced a sustained virologic response in 21% of transplant recipients with recurrent hepatitis C. However, 43% discontinued therapy due to adverse events (primarily severe anemia). Strategies to enable treatment with lower doses of ribavirin need to be explored.SamuelDidierDCentre HépatoBiliaire, Hôpital Paul Brousse Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris Sud, EA 3541, EPI 99-41 et Association Claude Bernard, Villejuif, France. didier.samuel@pbr.ap-hop-paris.frBizollonThierryTFerayCyrilleCRocheBrunoBAhmedSi Nafa SiSNLemonnierCatherineCCohardMarielleMReynesMichelMChevallierMichelleMDucerfChristianCBaulieuxJacquesJGeffnerMichaelMAlbrechtJanice KJKBismuthHenriHTrepoChristianCengClinical TrialJournal ArticleMulticenter StudyRandomized Controlled TrialResearch Support, Non-U.S. Gov'tUnited StatesGastroenterology03746300016-50850Antiviral Agents0Interferon alpha-20Interferon-alpha0RNA, Viral0Recombinant Proteins49717AWG6KRibavirinEC 2.6.1.2Alanine TransaminaseIMAlanine TransaminasebloodAntiviral Agentsadverse effectstherapeutic useDrug Therapy, CombinationFemaleHepacivirusgeneticsHepatitis C, Chronicblooddrug therapypathologysurgeryvirologyHumansInterferon alpha-2Interferon-alphaadverse effectstherapeutic useLiver TransplantationMaleMiddle AgedPostoperative CareRNA, ViralbloodRecombinant ProteinsRecurrenceRibavirinadverse effectstherapeutic useSafetyTreatment Outcome2003344020033285020033440ppublish1261290310.1053/gast.2003.50095S00165085021597371212743520030220201908170168-82783722002AugJournal of hepatologyJ HepatolRibavirin and interferon combination for recurrent post-transplant hepatitis C: which benefit beyond 6 months?274276274-6BizollonThierryTTrepoChristianCengCommentEditorialReviewNetherlandsJ Hepatol85038860168-82780Antiviral Agents49717AWG6KRibavirin9008-11-1InterferonsIMJ Hepatol. 2002 Aug;37(2):247-52. doi: 10.1016/s0168-8278(02)00109-512127430Antiviral Agentsadministration & dosageDrug Therapy, CombinationHepatitis C, Chronicdrug therapyHumansInterferonsadministration & dosageLiver TransplantationPostoperative Complicationsdrug therapyvirologyRecurrenceRibavirinadministration & dosage2220027201002003221402002720100ppublish1212743510.1016/s0168-8278(02)00200-3S01688278020020031058006319991215202203170022-131780 ( Pt 11)1999NovThe Journal of general virologyJ Gen VirolDynamic analysis of hepatitis C virus replication and quasispecies selection in long-term cultures of adult human hepatocytes infected in vitro.300730183007-301810.1099/0022-1317-80-11-3007Primary human hepatocytes were used to develop a culture model for in vitro propagation of hepatitis C virus (HCV). Production of positive- strand full-length viral RNA in cells and culture supernatants was monitored by PCR methods targeting three regions of the viral genome: the 5' NCR, the 3' X-tail and the envelope glycoprotein E2. De novo synthesis of negative-strand RNA was also demonstrated. Evidence for a gradual increase in viral components over a 3 month period was obtained by two quantitative assays: one for evaluation of genomic titre (quantitative PCR) and one for detection of the core antigen. Production of infectious viral particles was indicated by passage of infection to naive hepatocyte cultures. Reproducibility of the experiments was assessed using cultures from three liver donors and eleven sera. Neither the genotype, nor the genomic titre, nor the anti-HCV antibody content, were reliable predictive factors of serum infectivity, while the liver donor appeared to play a role in the establishment of HCV replication. Quasispecies present in hepatocyte cultures established from three different liver donors were analysed by sequencing hypervariable region 1 of the E2 protein. In all three cases, the complexity of viral quasispecies decreased after in vitro infection, but the major sequences recovered were different. These data strongly suggest that human primary hepatocytes are a valuable model for study of persistent and complete HCV replication in vitro and for identification of the factors (viral and/or cellular) associated with successful infection.RuminSylvieSINSERM U271, 151 cours Albert Thomas, 69424 Lyon Cedex 03, France1.BerthillonPascalePINSERM U271, 151 cours Albert Thomas, 69424 Lyon Cedex 03, France1.TanakaEijiESecond Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan2.KiyosawaKendoKSecond Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan2.TrabaudMary-AnneMAINSERM U271, 151 cours Albert Thomas, 69424 Lyon Cedex 03, France1.BizollonThierryTService d'Hépato-Gastroent érologie and Département de Chirurgie, Hô tel Dieu, 1 place de l'Hôpital, 69288 Lyon Cedex 02, France3.GouillatChristianCService d'Hépato-Gastroent érologie and Département de Chirurgie, Hô tel Dieu, 1 place de l'Hôpital, 69288 Lyon Cedex 02, France3.GriponPhilippePINSERM U522, Hôpital Pontchaillou, 35033 Rennes Cedex, France4.Guguen-GuillouzoChristianeCINSERM U522, Hôpital Pontchaillou, 35033 Rennes Cedex, France4.InchauspéGenevièveGINSERM U271, 151 cours Albert Thomas, 69424 Lyon Cedex 03, France1.TrépoChristianCINSERM U271, 151 cours Albert Thomas, 69424 Lyon Cedex 03, France1.engGENBANKAF045896AF045897AF045898AF045899AF045900AF045901AF045902AF045903AF045904AF045905AF045906AF045907AF045908AF045909AF045910AF045911AF045912AF045913AF045914AF045915AF045916AF045917AF045918AF045919AF045920AF045921AF045922AF045923AF045924Journal ArticleResearch Support, Non-U.S. Gov'tEnglandJ Gen Virol00773400022-13170RNA, ViralIMAdultAmino Acid SequenceBase SequenceCells, CulturedHepacivirusphysiologyHumansLivervirologyMolecular Sequence DataRNA, ViralanalysisSensitivity and SpecificityVirus Replication1999122199912201199912200ppublish1058006310.1099/0022-1317-80-11-3007trying2...
Recurrent hepatitis C infection is an important cause of progressive fibrosis, cirrhosis and graft loss after liver transplantation. Treatment for post-transplant recurrence results in sustained virological response (SVR) in up to 30% of cases. The aim of this study was to evaluate the impact of SVR on patients and graft survival.
Background: HCV reinfection after liver transplantation is universal and has an accelerated course with a high risk of progression to cirrhosis. It is now established that combination therapy with interferon (IFN) alpha and ribavirin may achieve a sustained virological response in 20% of transplanted patients. However, the optimal therapy for nonresponders remains an unresolved issue.
Background And Aims: Hepatitis C virus (HCV) reinfection after liver transplantation is frequent and leads to chronic hepatitis and cirrhosis. The use of antiviral therapy in this situation remains controversial. This study aimed to assess the safety and efficacy of interferon alfa-2b plus ribavirin for recurrent hepatitis C following liver transplantation.
Primary human hepatocytes were used to develop a culture model for in vitro propagation of hepatitis C virus (HCV). Production of positive- strand full-length viral RNA in cells and culture supernatants was monitored by PCR methods targeting three regions of the viral genome: the 5' NCR, the 3' X-tail and the envelope glycoprotein E2. De novo synthesis of negative-strand RNA was also demonstrated.