Evidence map›Paper›PMID 25815091›Full record

ArticleHepatology international2013

Immunological dysfunction during or after antiviral therapy for recurrent hepatitis C reduces graft survival.

Pratima Sharma, Amy Hosmer, Henry Appelman, Barbara McKenna, Mohammad S Jafri, Patricia Sullivan, Robert J Fontana, Anna S Lok

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 13 citations in OpenAlex.

  1. Impact of direct-acting antivirals for hepatitis C virus therapy on tacrolimus dosing in liver transplant recipients.Transplant infectious disease : an official journal of the Transplantation Society · 2019
    Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Pratima SharmaDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Amy HosmerDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Henry AppelmanDepartment of Pathology, University of Michigan, Medical Science Building-1, 1301, Catherine Road, Ann Arbor, MI, USA.
Barbara McKennaDepartment of Pathology, University of Michigan, Medical Science Building-1, 1301, Catherine Road, Ann Arbor, MI, USA.
Mohammad S JafriDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Patricia SullivanDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Robert J FontanaDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Anna S LokDivision of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912, Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Michigan Medicine · USUniversity Health System · USUniversity of Michigan–Ann Arbor · US

Funding

Predicting the burden of renal disease among liver transplant recipientsK08DK088946 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SHARMA, PRATIMA · 2011 to 2015
$765k
NIDDK NIH HHS K08 DK088946
6 · The paper itself

Abstract

introductionPegylated interferon and ribavirin (PEGIFN/RBV) therapy for recurrent hepatitis C after liver transplantation (LT) is associated with a lower sustained virological response (SVR) rate as well as more frequent side effects compared to non-transplant patients. We aimed to determine the incidence and clinical characteristics of LT recipients with recurrent hepatitis C who developed immunological dysfunction (ID) during or after PEG-IFN/RBV therapy and to assess its impact on patient and graft survival.

methodsSeventy-four deceased donor LT recipients with histological recurrence of hepatitis C were treated with PEG-IFN/RBV from 1/00 to 12/08. ID was defined as biopsy-proven rejection or moderate plasma cell hepatitis. Patients were followed up until death, re-LT or 30 September 2011.

resultsTwelve patients (16 %) had ID, 8 (10.7 %) had cholestasis without ID, while 54 had no ID/cholestasis during or after discontinuation of PEG-IFN/RBV therapy. Biopsy-proven acute cellular rejection prior to (hazard ratio = 4.87, p = 0.009) and type of immunosuppression at the time of initiation of PEG-IFN/RBV were the only independent predictors of ID. Patients who were on tacrolimus at the time of initiation of PEG-IFN/RBV had a significantly lower risk of ID compared to those who were on cyclosporine (HR 0.254, p = 0.023). Patients with ID had a trend toward a lower SVR rate (25 vs. 54 %, p = 0.18) and a significantly higher rate of graft failure (33 vs. 4 %, p = 0.004) compared to patients with no ID/cholestasis.

conclusionsID is common during or after PEG-IFN/RBV therapy for recurrent hepatitis C and frequently associated with decreased graft survival, trending toward low rates of SVR. Careful monitoring of liver biochemistries during or after PEG-IFN/RBV therapy with a low threshold to biopsy patients and particularly those receiving cyclosporine-based immunosuppression may improve outcomes in these patients.

Indexed as

Immunological dysfunctionLiver transplantationRecurrent hepatitis C

Identifiers

PMID25815091
PMCPMC4371864
OpenAlexW2059165344

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.