03). A total of 155 patients could be defined according to donor:recipient IL28B genotype pairs (CC versus non-CC). The respective frequencies were: donor non-CC:recipient non-CC = 34%, donor CC:recipient non-CC = 32%, donor non-CC:recipient CC = 19%, donor CC:recipient CC = 15% (Table 2). All patients had virological recurrence of HCV infection following liver transplantation. A total of 110/171 (64%) of recipients in whom the IL28B single-nucleotide polymorphism was successfully genotyped selleck products were diagnosed with recurrent hepatitis C by the fifth postoperative year. Time to recurrence was delayed
in recipients with the CC IL28B genotype compared to those with CT and TT genotypes (5-year recurrence: 78% versus 87% versus 100%, respectively; P = 0.0173). Multivariate Cox regression analysis showed that the recipient IL28B C allele was an independent predictor of delayed recurrence of hepatitis
C at 2 years: hazard ratio (HR), 0.619; 95% confidence interval (CI), 0.434-0.883; P = 0.0081 (Table 3). Pretransplant MELD score (HR, 1.05; 95% CI, 1.017-1.085; P = 0.0029) and pretransplant ALT RAD001 level (HR, 1.004; 95% CI, 1.001-1.007; P = 0.0042) were associated with shorter time to recurrence. The recipient IL28B C allele remained an independent predictor of delayed recurrence of hepatitis C at 5 years: HR, 0.632; 95% CI, 0.466-0.856; P = 0.0031 (Table 3). Pretransplant MELD score and pretransplant ALT level were both also associated with shorter time to recurrence at 5 years. The relationship between recipient IL28B genotype and time to recurrence of hepatitis C was independent of donor IL28B genotype (recipient IL28B genotype, P = 0.030 and P = 0.015 when donor IL28B genotype was forced into the 2-year and 5-year models). Among patients for whom donor liver IL28B genotype was available, recurrent hepatitis
C was diagnosed in 85/172 (49%) at 2 years selleck screening library post-OLT, and in 114/172 (66%) at 5 years post-LT. Donor IL28B genotype was not associated with time to recurrence of hepatitis C (log-rank P = 0.5566 and 0.3369, for 2-year and 5-year survival analyses, respectively). Analysis of the relationship between IL28B genotype and SVR was limited to patients for whom both recipient and donor IL28B genotype was available. A total of 65 patients received antiviral therapy for recurrent hepatitis C, 50 patients were treated with pegIFN, 15 were treated with standard IFN (77%), and 57 patients (92%) received combination therapy with RBV. Ribavirin starting dose was titrated to renal function. Five patients could not be evaluated for SVR: one patient was recently treated and had not reached the end of follow-up, three died due to sepsis within 6 months of stopping treatment and before they reached the end of follow-up, and one patient completed their therapy in another center.