Transplant SVR

[mikesimon]

What is you opinion about a liver transplant achieving SVR? Will HCV appear on biopsy and, if so, how common is it and how significant is it?
Thank you,
Mike

[Thomas D Schiano, MD]

interferon treatment is problematic for recurrent HCV after liver transplantation.  it is more difficult to tolerate in part due to the other meds one needs to take.  SVR are still dependent on genotype and unfortunately are lower than usual with genotype 1 SVR about 20-25% in most studies.  this occurs in part due to the need to dose reduce or suboptimally dose patients due to the side affects, such as anemia. everyone is viral load (+) after a liver transplant and when the liver tests rise a liver biopsy is indicated which might then show recurrent HCV.

i hope this helpful

[lucy161]

I had a liver transplant in 2001 and i am doing just great,If i had to do it again i would.What you are talking about .I don't know but if you thinking about having a transplant go for it.you just don't know how good you will feel.you are a new person.Lucy

[mikesimon]

I was transplanted in 2000. I believe the question I asked is quite clear.
Mike

[mikesimon]

Apparently my question was not as clear as I believed it to be.
I am SVR and a transplant recipient. I was transplanted in June 2000 and stopped treatment in June 2004. I test monthly with Heptimax (sensitivity of < 5 IU/ml) and have been consistently undetectable since April 2003. I treated for 73 weeks.
My question is:
Do you believe that a liver transplant recipient SVR (or a non-transplant SVR, for that matter) might still show active HCV on biopsy?
And, if you do believe that it is possible, how common is it and how significant is it?
I was biopsied in June of 2006 and HCV was seen, albeit at a very low viral load.
Thank you, Mike

[Thomas D Schiano, MD]

mike, as long as the HCV viral load is (-) the SVR should persist especially if you are this far our from treatment.  There can be nonspecific chronic histological changes on liver biopsies in many patients, some of which we do not understand.  Consisitently patients show histological improvement in their biopsies when they have SVR after liver transplantation.  there can be changes of steatohepatitis that can sometimes be similar to viral hepatitis and sometimes patients receive HBV core (+) donor allografts.  congratulations on your SVR-i think you're doing OK.

[mikesimon]

Thank you for your time and expertise. I greatly appreciate it.
Mike