Early predictors of antiviral treatment response in liver transplant recipients with recurrent hepatitis C genotype 1.

The success of current antiviral treatment for hepatitis C virus ( HCV) recurrence in liver transplant ( LT) recipients remains limited. We aimed at evaluating the value of IL28 B genotype and early viral kinetics to predict response to standard treatment in the transplant setting. We retrospectively evaluated 104 LT recipients treated for HCV genotype 1 recurrence between 2001 and 2010. Baseline variables, including IL28 B genotype, and early viral kinetics were compared among patients who did or did not achieve a sustained virological response ( SVR). Logistic regression analyses of candidate variables were conducted to generate a reliable predictive model based on the minimum set of variables. Twenty-nine (28%) achieved an SVR. On multivariate analysis, the magnitude of HCV RNA decline at 4 weeks ( OR: 3.74, 95% CI: 1.64-9.39; P = 0.003) and treatment compliance ( OR: 35.27, 95% CI: 3.35-365.54; P = 0.003) were the only independent predictors of SVR. Favourable recipient IL28 B genotype significantly correlates with virological response at week 4 ( OR 3.23; 95% CI, 1.12-9.15; P = 0.03). By logistic regression analysis, a model including donor age, recipient rs12979860 genotype and viral load at 4 weeks showed the best predictive value for SVR with an area under the receiver operating curve of 0.861. Favourable recipient IL28 B genotype strongly correlates with the viral response at week 4 which is the strongest predictor of response. The combination of recipient IL28 B genotype and donor age with the week 4 response reliably estimates the probability of SVR early on-treatment and may facilitate therapeutic strategies incorporating new antiviral agents. [ABSTRACT FROM AUTHOR]