***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND S/ AIMS We evaluated the effect of antiviral therapy on fibrosis progression in patients with histological features of mild/moderate HCV disease recurrence defined by a Grading score≥4 and Staging score up to 3 ( Ishak ) at 1 year after liver transplantation . METHODS Seventy-three consecutive patients with mild/moderate recurrence were r and omized either to no treatment or to receive Pegilated-Interferon-alfa-2b and ribavirin for 52 weeks . Liver biopsies obtained at baseline ( 1 year after transplantation ) and 2 years afterwards were evaluated for assessment of disease progression , defined as worsening of at least 2 staging points or progression to stage 4 or higher . RESULTS As for these two major histological end points there were no statistically significant differences between the 2 groups ( 36.1 % vs. 50 % , p=0.34 and 36.1 % vs. 38.9 % , p=1 ) . Fifteen treated patients ( 41 % ) achieved a sustained virological response which was associated with a reduced risk of fibrosis worsening for both endpoints when compared to viremic patients ( p=0.04 ) . CONCLUSIONS Although antiviral-therapy was beneficial in preventing fibrosis progression in patients achieving a sustained virological response , the majority of the overall population of our patients with mild-moderate disease recurrence could not benefit from antiviral therapy either because they either could not be treated or did not respond to treatment ( EudraCT number : 2005 - 005760 ) Background . In this article , we explore the virological response to two types of interferon based treatment in recurrent hepatitis C virus in liver recipients who received thymoglobulin induction . Methods . Fifty consecutive patients were r and omized to receive PEG interferon alpha 2b ( 1.0 & mgr;g/kg per week ) , ribavirin ( 800 mg/d ) plus amantadine ( 200 mg/d ) , or PEG interferon alpha 2b ( 1.0 & mgr;g/kg per week ) plus ribavirin ( 800 mg/d ) . The primary endpoint was absence of hepatitis C virus RNA 6 months posttreatment . The secondary endpoint was change in fibrosis at 1 year . Results . Only 30 patients completed 1 year of treatment . In an intention to treat analysis , the sustained virological response ( SVR ) rate was 26 % in I/R/A group and 50 % in I/R group . By per protocol , the overall SVR rate was 57 % . Fibrosis progression by at least one stage was noted in 37 % patients . Twenty-nine percent of patients who achieved SVR had shown fibrosis progression by at least one stage whereas 46 % nonresponders showed fibrosis progression ( P = NS ) . Conclusion . This is the first study exploring the efficacy of pegylated interferon-based antiviral treatment in patients who received a steroid-free protocol . Our data is encouraging and shows that if liver transplant recipients can tolerate treatment for 1 year there is a reasonable chance of SVR OBJECTIVES To analyze sources search ed in Cochrane review s , to determine the proportion of trials included in review s that are indexed in major data bases , and to compare the quality of these trials with those from other sources . METHODS All new systematic review s in the Cochrane Library , Issue1 2001 , that were restricted to r and omized controlled trials ( RCTs ) or quasi- RCTs were selected . The sources search ed in the review s were recorded , and the trials included were checked to see whether they were indexed in four major data bases . Trials not indexed were checked to determine how they could be identified . The quality of trials found in major data bases was compared with those found from other sources . RESULTS The range in the number of data bases search ed per review ranged between one and twenty-seven . The proportion of the trials in the four data bases were Cochrane Controlled Trials Register = 78.5 % , MEDLINE = 68.8 % , Embase = 65.0 % , and Science/Social Sciences Citation Index = 60.7 % . Search ing another twenty-six data bases after Cochrane Controlled Trials Register ( CCTR ) , MEDLINE , and Embase only found 2.4 % additional trials . There was no significant difference between trials found in the CCTR , MEDLINE , and Embase compared with other trials , with respect to adequate allocation concealment or sample size . CONCLUSIONS There was a large variation between review s in the exhaustiveness of the literature search es . CCTR was the single best source of RCTs . Additional data base search ing retrieved only a small percentage of extra trials . Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials The aim of the study was to observe the frequency of neutropenia during Pegylated Interferon/Ribavirin therapy  in patient with chronic hepatitis C ; to compare the efficacy of two strategies of management of neutropenia -- with Interferon dose modification and with Neupogen administration ; to compare the effectiveness rate of sustained viral response ( SVR ) in patients with Pegylated Interferon dose modification and in patients treated by using granulocyte colony-stimulating factor G-CSF-filgrastim .  ( Neupogen ) . Study enrolled 47 patients with chronic active hepatitis C , aged 23 - 64 . ( 38 male and 9 female ) . All patients had HCV genotype 1b . Significant neurtopenia ( ANC<750 mm3 ) and severe neurtopenia ( ANC<500 mm3 ) developed in 41 of 47 patients ( 87 % ) . 41 patients with neurtopenia were r and omized into two groups . The first group--22 patients who received granulocyte colony-stimulating factor ( G-CSF , or filgrastim ) 300 mcg s/c weekly for correction of neutropenia and the second group--19 patients treated either with Interferon dose reduction or temporarily inhibit of Interferon treatment . In all 22 patients of the first group neutropenia was normalized without reduction and /or inhibit of Pegylated interferon . Neupogen was well tolerated and in all 22 patients the improvement of quality of life ( QOL ) was observed . It was concluded that dose reduction or temporary inhibit of Pegylated Interferon in the second group negatively acts on antiviral treatment response in patients with HCV genotype 1 . In patients with PEG-IFN/RBV therapy Neupogen effectively manages neutropenia and gives opportunity to maintain interferon dose ( without reduction ) . Neupogen has the potential to improve adherence rates , which may in turn improve SVR Ischemic preconditioning ( IPC ) has the potential to decrease graft injury and morbidity  after liver transplantation . We prospect ively investigated the safety and efficacy of 5 minutes of IPC induced by hilar clamping in local deceased donor livers r and omized 1:1 to st and ard ( STD ) recovery ( N = 28 ) or IPC ( N = 34 ) .  Safety was assessed by measurement of heart rate , blood pressure , and visual inspection of abdominal organs during recovery , and efficacy by recipient aminotransferases ( aspartate aminotransferase [ AST ] and alanine aminotransferase [ ALT ] , both measured in U/L ) , total bilirubin , and international normalized ratio of prothrombin time ( INR ) after transplantation .  IPC performed soon after laparotomy did not cause hemodynamic instability or visceral congestion . Recipient median AST , median ALT , and mean INR , in STD vs. IPC were as follows : day 1 AST 696 vs. 841 U/L ; day 3 AST 183 vs. 183 U/L ; day 1 ALT 444 vs. 764 U/L ; day 3 ALT 421 vs. 463 U/L ; day 1 INR 1.7 + /- .4 vs. 2.0 + /- .8 ; and day 3 INR 1.3 + /- .2 vs. 1.4 + /- .3 ; all P > .05 . No instances of nonfunction occurred . The 6-month graft and patient survival STD vs. IPC were 82 vs. 91 % and median hospital stay was 10 vs. 8 days ; both P > .05 . In conclusion , deceased donor livers tolerated 5 minutes of hilar clamping well , but IPC did not decrease graft injury . Further trials with longer periods of preconditioning such as 10 minutes are needed BACKGROUND & AIMS Recurrence of hepatitis C virus ( HCV ) infection is a relevant problem of liver transplantation programs . We evaluated the effect of antiviral therapy on disease progression in 81 HCV-infected liver transplantation recipients . METHODS Patients with mild hepatitis C recurrence ( fibrosis stage F0 to F2 , n = 54 ) were r and omized to no treatment ( group A , n = 27 ) or peginterferon alfa-2b/ribavirin for 48 weeks ( group B , n = 27 ) . Patients with severe recurrence ( F3 to F4 , cholestatic hepatitis ) were treated ( group C , n = 27 ) . All patients ( n = 81 ) underwent a liver biopsy  at baseline and after follow-up ; paired hepatic venous pressure gradient ( HVPG ) measurements were available in 51 patients . RESULTS Thirteen ( 48 % ) patients of group B and 5 ( 18.5 % ) of group C achieved sustained virological response . Liver fibrosis progressed > or = 1 stage in 40 ( 49 % ) of 81 patients : 19 ( 70 % ) of group A versus 7 ( 26 % ) of group B ( P = .001 ) and in 14 ( 54 % ) of group C. HVPG increased ( 6.5 to 13 mm Hg , P < .01 ) in patients in whom fibrosis worsened , whereas it decreased ( 5 to 3.5 mm Hg , P = .017 ) or remained unchanged in those with fibrosis improvement or stabilization , respectively . The only variable independently associated with fibrosis improvement/stabilization was treatment ( odds ratio [ OR ] = 3.7 , 95 % confidence interval [ CI ] 1.3 to 10 , P = .009 ) . Among treated patients , alanine aminotransferase ( ALT ) normalization and viral clearance were independently associated with histological or hemodynamic improvement/stabilization ( OR 5.3 , 95 % CI 1.5 to 18 , P < .01 ; OR 7.4 , 95 % CI 1.4 to 38 , P = .01 ; respectively ) . CONCLUSIONS Our data demonstrate that in liver transplantation recipients , antiviral therapy slows disease progression ( particularly in sustained virological responders ) , as shown by its effects on liver histology and on HVPG Allograft reinfection with hepatitis C virus ( HCV ) in transplant recipients occurs commonly and represents a major concern in the transplant setting . Suppression of viral replication in HCV transplant patients should prevent or delay progression to cirrhosis and graft failure . In this ongoing study , we present preliminary data from a prospect i ve trial of st and ard interferon ( IFN ) alpha-2b ( 2 million units daily ) for 3 months and subsequent peginterferon ( PEG IFN ) alpha-2b ( 1.5 microg/kg/week ) for 9 months . IFN therapy was combined with ribavirin ( 10 to 12 mg/kg ) . So far , HCV has become undetectable by qualitative PCR in 33 % of patients while 25 % had a reduction of HCV RNA to undetectable by the bDNA assay and 42 % had no virological response after 6 months of therapy . A biochemical response was detected in 42 % of patients . Improvement of inflammatory activity was observed in 42 % of patients after 6 months . In three patients anemia necessitated administration of erythropoietin and three patients received granulocyte-colony stimulating factor ( G-CSF ) due to leucopenia [ corrected ] In conclusion , we observed that daily IFN alpha-2b and subsequent PEG IFN alpha-2b therapy in combination with ribavirin provides biochemical and virological benefits in transplant recipients with established recurrent HCV infection BACKGROUND / AIMS HCV infection recurs almost in all HCV-positive patients receiving liver transplantation and carries a poor prognosis . Aim of this study was to analyze efficacy and effect on survival of antiviral therapy in this clinical setting . METHODS Pegylated-interferon alpha-2b and ribavirin were administered at a dose of 1 microg/kg of bwt weekly and 600 - 800 mg/day . Planned duration of treatment was 24 or 48 weeks according to HCV genotype . Patients who failed to respond at week 24 were considered as non-responders . RESULTS 61 patients were enrolled . According to intention-to-treat analysis , 44 ( 72 % ) patients were considered as treatment failure ( 31 non-responders , 4 relapsers , 9 dropout ) . Sustained virological response was achieved in 17 cases ( 28 % ) . Genotype 2 , higher doses of antivirals and absence of histological cirrhosis were predictors of sustained virological response . In the follow up , patients with sustained virological response had a significantly lower mortality 
    Output:
    
Considering the lack of clinical benefit , there is currently no evidence to recommend or refute antiviral treatment for recurrent liver graft infection with hepatitis C virus .