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Cyclosporine inhibits hepatitis C virus in vitro

duction with Tacrolimus. Furthermore, the Cyclosporine appeared to work through a different pathway compared to interferon.

Then, the researchers retrospectively examined the cases of 115 people infected with hepatitis C who had undergone liver transplantation at the University of Florida between 1991 and November 2002 and had received interferon-based therapy alongside their anti-rejection medications. After 48 weeks, 46 percent of the patients taking Cyclosporine had achieved a sustained virological response, compared with just 27 percent of the patients taking Tacrolimus.

"Our study suggests that Cyclosporine may play a beneficial role as primary immunosuppression for patients transplanted for HCV infection and may offer an advantage to Tacrolimus in those patients undergoing IFN-based therapy," the authors report. In addition, they confirm antiviral activity by the drug in cell cultures, having found that, "combination of Cyclosporine and interferon achieve better antiviral effect than either one alone."

Of note, considerably more patients taking Tacrolimus had to reduce or stop the therapy due to side effects. Also of possible significance, more patients taking Cyclosporine died, mostly due to infections and hepatitis complications, though this may be attributable to a longer follow-up period for that group.

Still, the indication that Cyclosporine had novel antiviral properties invites further investigation, the authors write. A prospective randomized comparative trial between cyclosporine and TAC should further evaluate their observations.

"Due to the accelerated rate of disease progression and graft failure after liver transplantation in HCV patients," the authors conclude, "it will be very important to determine the ideal immunosuppression regimen."


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Source:John Wiley & Sons, Inc.


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