RIBAVIRIN THERAPY FOR HEPATITIS-C INFECTION FOLLOWING LIVER-TRANSPLANTATION

Hepatitis C infection following orthotopic liver transplantation may l ead to progressive chronic graft dysfunction. In this study, seven liv er transplant recipients with chronic allograft dysfunction due to hep atitis C infection (one acquired and six recurrent infections) were tr eated with oral ribavirin for 6 months. Symptoms of lethargy, nausea a nd anorexia improved in all patients within 2 weeks of starting the dr ug, with a fall in serum AST of at least 40 % by this time. Ribavirin- induced haemolysis was clinically significant in three patients, neces sitating a reduction in the daily dose of ribavirin from 1.2 g to 0.2 g. Comparison of the pre- and post-treatment biopsy specimens in the f our patients who tolerated the full dose of ribavirin and who had norm al AST levels at the end of 6 months of treatment showed significant h istological improvement with reduction in either lobular or periportal inflammation in all of the patients and a reduction in periportal fib rosis in one patient. HCV RNA remained detectable in serum in all of t he patients at the end of the study.