Simeprevir/pegylated interferon/ribavirin triple therapy for recurrent hepatitis C after living donor liver transplantation

Abstract

Aim: Simeprevir (SMV) is a protease inhibitor which demonstrates good tolerability and high antiviral response in patients with hepatitis C. The clinical outcomes of triple therapy using simeprevir, pegylated interferon and ribavirin (SMV/PEG IFN/RBV) for recurrent hepatitis C after living donor liver transplantation (LDLT) have not been well reported. In this study, we assessed the outcomes of patients with recurrent hepatitis C (genotype 1) after LDLT who received triple therapy at our hospital.Methods: SMV/PEG IFN/RBV was administrated for 12 weeks (triple therapy), followed by another 12 weeks or extended period of PEG IFN/RBV (dual therapy). Virological response, interaction with calcineurin inhibitors and adverse events were retrospectively analyzed.Results: Ten patients with recurrent hepatitis C after LDLT completed 12 weeks of triple therapy. Nine patients achieved rapid or early virological response, and one patient was a nonresponder. The nine responders received subsequent dual therapy, and the duration of dual therapy was extended (24 to 36 weeks) in five cases. Although one patient was in relapse 8 weeks after completing the standard duration (12 weeks) of dual therapy, eight patients achieved sustained virological response for 12 weeks (SVR12). The SVR12 rate was 80%. Trough levels of calcineurin inhibitor did not show marked changes after introduction of SMV in all cases. There were no major adverse events associated with SMV.Conclusion: SMV treatment may be a safe and effective option for recurrent hepatitis C after LDLT.

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review

“…Simeprevir with Peg-IFN and ribavirin therapy was recently published from Japan in a small cohort (n = 10) of post transplant rHCV infected patients following live donor liver transplantation. SVR 12 was 66.6 % [77].…”

Antiviral therapy of hepatitis C with 1 genotype after liver transplantation

“…По данным еще одного японского исследования, УВО был достигнут у 80% пациентов, при этом симепревир существенно не влиял на плазменную концентрацию ингибиторов кальциневрина, и самое главное -данная схема имела улучшенный профиль безопасности: не было описано случаев тяжелых нежелательных явлений, все пациенты смогли завершить полный курс противовирусной терапии [51].…”