Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study.

Autor:	González-Corvillo C; Department of Nephrology, Hospital Virgen del Rocío, Sevilla, Spain., Beneyto I; Department of Nephrology, Hospital La Fe, Valencia, Spain., Sánchez-Fructuoso A; Department of Nephrology, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain., Perelló M; Department of Nephrology, Hospital Vall d'Hebrón, Barcelona, Spain., Alonso A; Department of Nephrology, Complejo Hospitalario A Coruña, A Coruña, Spain., Mazuecos A; Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain., Jiménez C; Department of Nephrology, Hospital La Paz, Madrid, Spain., Zárraga S; Department of Nephrology, Hospital de Cruces, Vizcaya, Spain., Paul J; Department of Nephrology, Hospital Miguel Servet, Zaragoza, Spain., Lauzurica R; Department of Nephrology, Hospital Germans Trías i Pujol, Barcelona, Spain., Hernández D; Department of Nephrology, Hospital Universitario Carlos Haya, IBIMA, REDinREN RD16/0009/0006, Málaga, Spain., Guirado L; Department of Nephrology, Fundación Puigvert, REinREN RD16/0009/0019, Barcelona, Spain., Franco A; Department of Nephrology, Hospital de Alicante, Alicante, Spain., Ruiz JC; Department of Nephrology, Hospital Marqués de Valdecilla, IDIVAL, REDinREN RD16/0009/0027, Santander, Spain., Llorente S; Department of Nephrology, Hospital Virgen de la Arrixaca, Murcia, Spain., Crespo M; Department of Nephrology, Hospital del Mar, Barcelona, Spain., Rodríguez-Benot A; Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain., de Gracia Guindo MDC; Department of Nephrology, Hospital Universitario Virgen de las Nieves, Granada, Spain., Díaz-Corte C; Department of Nephrology, Hospital Central de Asturias, REDinREN RD16/0009/0021, Asturias, Spain., Gentil MÁ; Department of Nephrology, Hospital Virgen del Rocío, Sevilla, Spain.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2019 Nov 18; Vol. 5 (12), pp. e510. Date of Electronic Publication: 2019 Nov 18 (Print Publication: 2019).
DOI:	10.1097/TXD.0000000000000954
Abstrakt:	Background: Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. Methods: Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. Results: Patients (N = 226) were mostly male (65.9%) aged 56.1 ± 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 ± 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 ± 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4-41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. Conclusions: Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu