Benefits of Transplanting Hepatitis C Infected Livers May Outweigh Risks

MedicalResearch.com Interview with:

Jagpreet Chhatwal, PhD Assistant Professor, Harvard Medical School MGH Institute for Technology Assessment Boston, MA

Dr. Chhatwal

Jagpreet Chhatwal, PhD
Assistant Professor, Harvard Medical School
MGH Institute for Technology Assessment
Boston, MA and

Sumeyye Samur PhD Postdoctoral Fellow MGH-Harvard Medical School

Dr. Samur

Sumeyye Samur PhD
Postdoctoral Fellow
MGH-Harvard Medical School

MedicalResearch.com: What is the background for this study?

Response: The number of patients who are in need of liver transplant continues to rise whereas the availability of organs remains limited, therefore, it becomes is important to utilize all available livers.

Under the current practices, only Hep-C infected patients are eligible to receive infected livers. However, with the advent of high efficacy drugs, number of infected recipients has decreased over the last decade. On the other hand, with the rise of opioid use, number of Hep-C infected organs increased. With this contradiction, it becomes paramount of importance to utilize the infected livers which could help save more lives on the transplant waiting list.

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Improved Longevity of Hepatitis C Patients Who Respond To Therapy

Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The NetherlandsMedicalResearch.com Interview with:
Adriaan J. van der Meer, MD, PhD
Department of Gastroenterology and Hepatology
Erasmus MC University Medical Center Rotterdam,
Rotterdam, the Netherlands

Medical Research: What is the background for this study? What are the main findings?

Dr. van der Meer: This study was performed in order to assess the association between the virological response to antiviral therapy and the long-term clinical outcome among patients with advanced liver disease, who have the highest risk of cirrhosis-related complications and death due to their chronic viral infection. At the time this study was initiated there was scarce data on the relation between a sustained virological response (SVR; sustained elimination of hepatitis C RNA) and reduced all-cause mortality, the most definite clinical endpoint. With our large international multicenter cohort study we were able to show this association. After 10 years of follow-up the cumulative mortality rate was 9% among patients with SVR as compared to 26% among patients without SVR after antiviral therapy (p<0.001). The current JAMA research letter concerns a related analyses, in which we compared the survival among patients included in our cohort with that of an age- and sex-matched general population. Importantly, the survival among patients with SVR was comparable to the general population, despite the fact that all these patients had histological proof of advanced hepatic fibrosis. In contrast, the survival among patients without SVR was markedly lower as compared to the general population.

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A risk for hepatocellular carcinoma still persists long-term after sustained virological response in patients with hepatitis C associated liver cirrhosis

MedicalResearch.com: eInterview with: Soo Aleman Department of Gastroenterology and Hepatology, and Infectious Diseases Karolinska University Hospital, at Karolinska Institute 171 76 Stockholm, Sweden,Soo Aleman
Department of Gastroenterology and Hepatology, and Infectious Diseases
Karolinska University Hospital, at Karolinska Institute
171 76 Stockholm, Sweden,


MedicalResearch.com: What are the main findings of the study?

Answer: In this long-term, prospective study of 351 hepatitis C infected patients with liver cirrhosis, we found a reduced but persistent risk for hepatocellular cancer after successful treatment with eradication of the virus. This risk for hepatocellular cancer remained at a level of 1% per year for those with sustained virological response, and could persist as long as 8 years after eradication.
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