Peg-IFN and ribavirin treatment for recurrence of genotype 2 and 3 hepatitis C after liver transplantation

Ackefors, Malin; Castedal, Maria; Dahlgard, Olav; Verbaan, Hans; Gjertsen, Henrik; Wernerson, Annika; Weiland, Ola

doi:10.3109/00365548.2014.984322

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…On the basis of clinical experience at the transplantation units at the Karolinska and Sahlgrenska University Hospitals,[ 48 ] the dose of ribavirin given twice daily can be calculated using the following formula:…”

Section: Treatment After Liver Transplantationmentioning

confidence: 99%

Treatment of hepatitis C virus infection for adults and children: Updated Swedish consensus recommendations

Lagging

Wejstål

Norkrans

et al. 2015

Infectious Diseases

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In a recent expert meeting, Swedish recommendations for the treatment of HCV infection were updated. An interferon-free combination of direct-acting antiviral agents was recommended as the first line standard-of-care treatment for chronic HCV infection. Interferon-based therapy should be considered as a second line option after an individual benefit-risk assessment. Treatment is strongly recommended for HCV infected patients with bridging fibrosis or cirrhosis (Metavir stages F3–4), before and after liver transplantation, and in the presence of extra-hepatic manifestations. Additionally, patients with moderate liver fibrosis (stage F2) as well as women in need of in vitro fertilisation should be prioritised for therapeutic intervention. Treatment indications for people who inject drugs, children, chronic kidney disease and HIV co-infection are also discussed.

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Section: Treatment After Liver Transplantationmentioning

confidence: 99%

Treatment of hepatitis C virus infection for adults and children: Updated Swedish consensus recommendations

Lagging

Wejstål

Norkrans

et al. 2015

Infectious Diseases

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“…Tolerance of the previous standard-of-care (SOC) treatment, pegylated-interferon (peg-IFN) and ribavirin (RBV), in cirrhotic patients as well as LT recipients was suboptimal due to severe side-effects such as infections and increased risk of rejection, leading to frequent cessation of therapy [7]. Furthermore, peg-IFN and RBV combination therapy in LT patients yielded SVR rates as low as 20–45%, with only 15–30% of genotype 1 infected recipients achieving SVR [3, 8].…”

Section: Introductionmentioning

confidence: 99%

No need to discontinue hepatitis C virus therapy at the time of liver transplantation

Skoglund¹,

Lagging²,

Castedal³

2019

PLoS ONE

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Objectives Direct antiviral agents (DAA) has dramatically improved the therapy outcome of hepatitis C-virus (HCV) infection, both on the waiting-list and post liver transplantation (LT). DAA are generally well-tolerated in patients with mild to moderate liver and kidney failure, but some DAAs are contraindicated in patients with severe dysfunction of these organs. Today there are few studies of peri-LT DAA use and treatment is commonly discontinued at the time of LT. We report here our experience of DAA therapy given continuously in the perioperative LT period in a real-life setting in Sweden. Material In total 10 patients with HCV-cirrhosis, with or without hepatocellular carcinoma, and a median age of 60.5 years (range, 52–65) were treated with DAAs on the waiting list for LT, and continued in the early postoperative period without any interruption, on the basis of not having reached a full treatment course at the time of LT. Sofosbuvir and a NS5A inhibitor with or without ribavirin, or sofosbuvir and ribavirin only, were given. The distribution of genotypes was genotype 1 and 3, in 4 and 6 patients, respectively. Six of the 10 patients had previously been treated with IFN-based therapy. Results There were no adverse events leading to premature DAA discontinuation. All recipients achieved a sustained viral response 12 weeks after end-of-treatment (SVR12). At the time of LT the median MELD-score was 16.5 (range 7–21), CTP-score 9.0 (range 5–10), creatinine 82.5 μmol/L (range 56–135, reference 60–105), bilirubin 33 μmol/L (range 16–79, reference 5–25) and PK-INR 1.5 (range 1.1–1.8). The median duration of DAA therapy was 60 days (range 18–132) pre-LT, 54 days post-LT (range 8–111 days) and in total 15.5 weeks (range 12–30 weeks). Conclusion Interferon-free DAA therapy of HCV-infection given in the immediate pre- and post-operative LT period is safe, well-tolerated and yields high SVR rates.

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INF-free sofosbuvir-based treatment of post-transplant hepatitis C relapse – a Swedish real life experience

Castedal

Segenmark

Cederberg

et al. 2017

Scandinavian Journal of Gastroenterology

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Peg-IFN and ribavirin treatment for recurrence of genotype 2 and 3 hepatitis C after liver transplantation

Cited by 3 publications

References 26 publications

Treatment of hepatitis C virus infection for adults and children: Updated Swedish consensus recommendations

Treatment of hepatitis C virus infection for adults and children: Updated Swedish consensus recommendations

No need to discontinue hepatitis C virus therapy at the time of liver transplantation

INF-free sofosbuvir-based treatment of post-transplant hepatitis C relapse – a Swedish real life experience

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