High post‐transplant virological response in hepatitis C virus infected patients treated with pretransplant protease inhibitor‐based triple therapy

Verna, Elizabeth C.; Shetty, Kirti; Lukose, Thresiamma; Terry, Nicole; Mentore, Kimiknu; Olsen, Sonja K.; Fox, Alyson N.; Dove, Lorna; Brown, Robert S.

doi:10.1111/liv.12616

Cited by 16 publications

(7 citation statements)

References 23 publications

(67 reference statements)

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“…The addition of first-generation protease inhibitors (PIs), boceprevir and telaprevir, to PR is clearly associated with an increase in response rates in G1 infected patients [12][13][14][15][16], including some patients awaiting LT. Verna et al [17] reported the results of triple therapy in a small cohort of HCV-infected cirrhotic patients (n = 29) on the waiting list for LT (Child-Pugh A 62%, Child-Pugh B 38%). The median duration of treatment was 27 weeks.…”

Section: Interferon-based Regimensmentioning

confidence: 98%

Treatment options in patients with decompensated cirrhosis, pre- and post-transplantation

Gambato

Lens

Navasa

et al. 2014

Journal of Hepatology

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Interferon-based treatments have a poor safety profile and limited efficacy in patients with advanced liver disease and in patients with hepatitis C (HCV) recurrence after liver transplantation (LT). Despite the recent approval of the first interferon-free regimen, which will be followed by several other interferon-free combinations in 2014 and 2015, data in patients with advanced cirrhosis and hepatitis C after LT are still limited. One study has already proven the concept that graft HCV infection can be prevented in a significant proportion of patients by treating them with sofosbuvir and ribavirin while awaiting LT. Two interferon-free regimens have also demonstrated a high efficacy in patients with hepatitis C recurrence after transplantation. Before these treatment strategies can be implemented in clinical practice, a few issues need to be addressed: (1) safety and efficacy of new antivirals in patients with decompensated cirrhosis, (2) the impact of viral clearance on liver function, (3) the potential consequences of virological failure (and the selection of multi-drug resistant HCV strains) in patients with decompensated cirrhosis or with severe hepatitis C recurrence after LT, and (4) drug-drug interactions (DDI) profiles. Finally, in the transplant setting it is also relevant to learn which strategy is most cost-effective in minimizing the negative impact of hepatitis C: preventing graft infection by treating patients before transplantation or treating hepatitis C recurrence after LT.

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Section: Interferon-based Regimensmentioning

confidence: 98%

Treatment options in patients with decompensated cirrhosis, pre- and post-transplantation

Gambato

Lens

Navasa

et al. 2014

Journal of Hepatology

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“…SVR12 rates increased approximately up to 60% -80% in HCV GT1-infected non-transplant patients (9,10) and up to 52% in liver transplant recipients since 2011, when a new family of medicines known as first generation direct-acting antivirals (DAAs) telaprevir and boceprevir were developed and introduced for use in combination with PegINF/RBV (8). PegINF, however, is associated with substantial side effects, which affect adherence to the interferon-based therapy (11).…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

“…In clinical studies, the regimen consisting of OBV/PTV/r + DSV ± RBV was highly efficacious to treat HCV GT1a or GT1b infection, including patients with compensated cirrhosis, liver transplant or human immunodeficiency virus 1 (HIV-1) co-infection. The observed SVR12 rate ranged from 92% to 100% (8,(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

See 1 more Smart Citation

Direct-Acting Antivirals Ombitasvir / Paritaprevir / Ritonavir + Dasabuvir with or Without Ribavirin in Hepatitis C Virus (HCV) Genotype 1-Infected Treatment-Naive or Treatment-Experienced Patients with or Without Cirrhosis: Real-Life Experience in Lithuania and Latvia

et al. 2018

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“…The major concern with these regimens was the low tolerability rate. SAEs caused the discontinuation of therapy in 31% of patients (18). In the absence of alternative therapies, IFN-based therapy can only be an option for patients with a chance of better response rates, namely those with genotype 2-3 infection, IL28B CC polymorphism, CPT score <7, MELD<18, or HCC as indication for transplantation (19).…”

Section: Ifn-based Therapiesmentioning

confidence: 99%

New modalities in the treatment of HCV in pre and post - transplantation setting

Araz

Durand²,

Gürakar³

2015

Turk J Gastroenterol

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End-stage liver disease and hepatocellular carcinoma (HCC) secondary to hepatitis C virus (HCV) infection are the leading indications for liver transplantation (LT) in developed countries. Recurrence of HCV following LT is universal if the recipient has detectable serum HCV RNA at the time of LT. Recurrent HCV has an accelerated course and is associated with poor long term patient and graft survival. Interferon (IFN)-based regimens have achieved low Sustained Virological Rates (SVR) in this setting and are associated with a high rate of adverse events, resulting in treatment discontinuation. With advances in understanding the HCV life cycle, drugs targeting specific steps, particularly inhibiting the NS3/4A protease, NS5B RNA dependent RNA polymerase and the NS5A protein, have been developed. Sofosbuvir (SOF), a nucleotide analogue inhibitor of NS5B polymerase was the first compound to enter the market. Combinations of SOF with new HCV antivirals from other classes have allowed for IFN-free regimens with low rates of adverse events and SVR rates >90%. With the availability of newer agents, the approach to the treatment of HCV infection during the pre-and post-liver transplantation period has changed. We will hereby review the current status of HCV treatment and discuss the potential future therapies in the transplant setting.

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High post‐transplant virological response in hepatitis C virus infected patients treated with pretransplant protease inhibitor‐based triple therapy

Abstract: Overall SVR12 and pTVR12 rates are high among patients treated with PI-based triple therapy while awaiting LT, even in this difficult to treat population. However, caution is needed as early discontinuation and serious adverse events are common.

Cited by 16 publications

References 23 publications

Treatment options in patients with decompensated cirrhosis, pre- and post-transplantation

Treatment options in patients with decompensated cirrhosis, pre- and post-transplantation

Direct-Acting Antivirals Ombitasvir / Paritaprevir / Ritonavir + Dasabuvir with or Without Ribavirin in Hepatitis C Virus (HCV) Genotype 1-Infected Treatment-Naive or Treatment-Experienced Patients with or Without Cirrhosis: Real-Life Experience in Lithuania and Latvia

New modalities in the treatment of HCV in pre and post - transplantation setting

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