Therapy With Direct-Acting Antiviral Agents for Hepatitis C in Liver Transplant Recipients
| Autor: | F. Valverde López, EJ Ortega Suazo, F. Vadillo Calles, M. D. Espinosa Aguilar, A. López Garrido, F. Nogueras López |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Simeprevir
Adult Male medicine.medical_specialty Daclatasvir Cirrhosis medicine.medical_treatment 030231 tropical medicine Population Hepacivirus Liver transplantation Gastroenterology Antiviral Agents 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Spontaneous bacterial peritonitis Internal medicine medicine Humans education Retrospective Studies Transplantation education.field_of_study business.industry Hepatitis C Middle Aged medicine.disease Liver Transplantation Treatment Outcome Tolerability 030211 gastroenterology & hepatology Surgery Female Virus Activation business medicine.drug |
| Zdroj: | Transplantation proceedings. 50(2) |
| ISSN: | 1873-2623 |
| Popis: | Background Recurrent infection with the hepatitis C virus (HCV) after liver transplantation (LT) is associated with decreased graft and patient survival. Direct-acting antiviral (DAA) therapies have changed the landscape of HCV due to their excellent safety profile and cure rates. Our aim was to evaluate the efficacy and tolerability of antiviral therapy in recurrent HCV after LT with DAA therapy. Methods Our retrospective analysis included 46 LT recipients with HCV recurrence. Patients received therapy with DAA therapy between November 2014 and May 2016. Stage of fibrosis was documented by transient elastography (FibroScan). Results Thirty-three of the patients were men (71.7%), with a mean age of 59.6 years. Most patients were infected with HCV genotype 1 (71.7%) (1a = 7, 1b = 26) or genotype 3 (19.6%). Cirrhosis was present in 10 (21.7%). The most frequent immunosuppression regimen was tacrolimus + mycophenolate mofetil (MMF) (41.3%). Most patients received sofosbuvir + simeprevir (SOF+SMV) (n = 13, 28.3%) and sofosbuvir + daclatasvir (SOF+DCV) (n = 15, 32.6%). A virologic response at posttreatment week 12 was detected in 93.8% of the patients. Two patients failed treatment (1 had resistance-associated variants [RAVs] Y93H in NS5A). Three patients died due to chronic rejection, acute arterial thrombosis, and spontaneous bacterial peritonitis. Adverse events were observed in 23 patients (50%). The most common events were asthenia in 17 (37%) and headache in 6 (13%) patients. One patient discontinued treatment due to serious adverse events attributable to the drug's interaction with tacrolimus. Conclusions DAAs are safe and effective for use in treating HCV recurrence after LT, with results similar to those seen in the general population, including patients with cirrhosis. |
| Databáze: | OpenAIRE |
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