Science

Cyclosporine shows anti-HCV activity in vitro and in liver transplant recipients

Last Updated: 2006-02-06 8:44:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The immunosuppressive agent cyclosporine is active against hepatitis C virus (HCV) in vitro and its use can improve the chances of a sustained virologic response in HCV-infected liver transplant recipients, new research shows.

In previous studies, cyclosporine has shown activity against HIV, herpes simplex, and vaccinia viruses, according to the report in the January issue of Liver Transplantation. Now, Dr. Roberto J. Firbi, from the University of Florida in Gainesville, and colleagues evaluated the drug's ability to clear HCV in liver transplant recipients treated with interferon and ribavirin for 48 weeks after progressive histologic disease was identified.

The retrospective analysis involved 56 patients who were treated with a cyclosporine-based immunosuppressive regimen and 59 treated with one based on tacrolimus.

The sustained virologic response rate in the cyclosporine group was 46%, much higher than the 27% rate noted in the tacrolimus group (p = 0.03).

In vitro analysis showed that cyclosporine inhibited HCV replication in a dose-dependent fashion. Moreover, the mechanism involved is distinct from that used by interferon and an additive effect was seen when both drugs were given together.

"HCV infection is of major concern after liver transplantation due to universal recurrence, more rapid fibrosis progression, and potential graft failure," the authors state. The present findings suggest that cyclosporine is better than tacrolimus at halting HCV replication, but confirmation in randomized controlled trials is needed.

Liver Transpl 2006;12:51-57.