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Evidence summaries

Antiviral Therapy for Recurrent Liver Graft Infection with Hepatitis C Virus

Antiviral therapy for recurrent liver graft infection with hepatitis C virus might possibly be of no clinical benefit, but there is insufficient evidence from adequate trials. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 11 studies with a total of 501 subjects. The patients were liver transplant recipients with proven hepatitis C recurrence. The interventions included antiviral therapy with single drug regimen or multidrug regimen of interferon, ribavirin, and amantadine. Only one or two trials were included under each comparison, and no difference was found in mortality, graft rejection, or in re-transplantation between intervention and control groups in any of the comparisons that reported these outcomes. There was no significant difference in proportion of participants who developed serious adverse events or in the number of serious adverse events between the intervention and control groups in the other comparisons that reported serious adverse events.

Comment: The quality of evidence is downgraded by by imprecise results (limited study size for each comparison), inconsistency (variability in outcomes), study quality (lack of appropriate blinding in most of the studies) and by indirectness (modern supportive drug therapies were not used and the follow-up time was too short).

References

  • Gurusamy KS, Tsochatzis E, Xirouchakis E, Burroughs AK, Davidson BR. Antiviral therapy for recurrent liver graft infection with hepatitis C virus. Cochrane Database Syst Rev 2010;(1):CD006803 [Review content assessed as up-to-date: 14 February 2013]. [PubMed].

Primary/Secondary Keywords