Sofosbuvir-Based Antiviral Therapy Is Highly Effective In Recurrent Hepatitis C in Liver Transplant Recipients

Faisal, Nabiha; Bilodeau, Marc; Al-Judaıbı, Bandar; Hirsch, Geri; Yoshida, Eric M.; Hussaini, Trana; Ghali, Maged P.; Congly, Stephen E.; Mang, M.; Leonard, Jennifer; Cooper, Curtis; Peltekian, Kevork M.; Renner, Eberhard L.; Lilly, Leslie

doi:10.1097/tp.0000000000001126

Cited by 33 publications

(7 citation statements)

References 17 publications

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“…We observed a remarkable SVR12 of 100% for pretransplant use and SVR12 of 94% for post-transplant use. Our results are comparable to previously reported rates in practice [101112]. The combination of DAAs was well tolerated with a low rate of adverse events.…”

Section: Discussionsupporting

confidence: 89%

“…Real-world studies have supported high SVR rates and excellent tolerability of DAA regimens in LT recipients with recurrent hepatitis C and mild to moderate fibrosis including combination regimens of SOF/LDV and SOF plus DCV [1011121516]. …”

Section: Discussionmentioning

confidence: 99%

“…Three recent observational studies using sofosbuvir-based therapy reported 100% SVR12 rates after completion of therapy [101112]. However, limited data are available on the efficacy and safety of DAAs in liver recipients in Asia.…”

Section: Introductionmentioning

confidence: 99%

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Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

et al. 2018

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PurposeThe proportion of liver recipients with HCV is gradually increasing in Korea. Limited data are available regarding the efficacy of direct antiviral agents (DAAs) in liver transplant recipients in Asia. We aimed to assess the efficacy and safety of DAAs in HCV-infected liver recipients in Korea.MethodsForty HCV-infected patients from 2 centers received DAAs in the pretransplant or posttransplant period between May 2015 and November 2016.ResultsDAA was administered in the pretransplant period in 6 patients and the posttransplant period in 34 patients. Dalastavir and asunaprevir (n = 2) and sofosbuvir/ledipasvir and ribvarin (n = 4) were used in the pretransplant period. HCV RNA was not detected before liver transplantation in all patients. Sustained virological response (SVR) at 12 and 24 weeks after liver transplantation was 100%. In the posttransplant period, 33 of 34 patients received sofosfovir-based therapy. SVR at 12 weeks in those patients was 94%. Recurrent virologic relapse developed in 2 patients because of HCC recurrence or treatment failure. Adverse events included anemia (n = 2) and abdominal discomfort (n = 1).ConclusionDAAs are an effective and well-tolerated treatment for HCV-infected recipients in Korea.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

et al. 2018

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“…Recent researchers documented excellent results of DAAs, especially in the treatments for patients with hepatitis C before LT. Sofosbuvir-based antiviral therapy is highly effective even in recurrent hepatitis C after LT [ 55 , 56 ], and the SVR rate of sofosbuvir-based therapy was reported as >90% even for hepatitis C in LT recipients [ 55 ]. In the recent data for hepatitis C patients, the SVR rates of sofosbuvir/daclatasvir [ 18 , 57 ] and sofosbuvir/ledipasvir [ 58 , 59 ] were reported as 95-100% and 90-97%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Fibrosing cholestatic hepatitis C in post-transplant adult recipients of liver transplantation

Hori

Onishi

Kamei

et al. 2016

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Hepatitis C recurrence continues to present a major challenge in liver transplantation (LT). Approximately 10% of hepatitis C virus (HCV)-positive recipients will develop fibrosing cholestatic hepatitis (FCH) after LT. FCH is clinically characterized as marked jaundice with cholestatic hepatic dysfunction and high titers of viremia. Pathologically, FCH manifests as marked hepatocyte swelling, cholestasis, periportal peritrabecular fibrosis and only mild inflammation. This progressive form usually involves acute liver failure, and rapidly results in graft loss. A real-time and precise diagnosis based on histopathological examination and viral measurement is indispensable for the adequate treatment of FCH. Typical pathological findings of FCH are shown. Currently, carefully selected combinations of direct-acting antivirals (DAAs) offer the potential for highly effective and safe regimens for hepatitis C, both in the pre- and post-transplant settings. Here, we review FCH caused by HCV in LT recipients, and current strategies for sustained virological responses after LT. Only a few cases of successfully treated FCH C after LT by DAAs have been reported. The diagnostic findings and therapeutic dilemma are discussed based on a literature review.

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“…However, regardless of the medication used, the objectives of HCV treatment have not changed: to prevent progression to cirrhosis and loss of the graft (12 –20). In HCV-infected patients, the achievement of sustained virological response (SVR) after treatment reduces the risk of progression to clinical decompensation or development of hepatocellular carcinoma in cirrhotic patients and can even result in histological improvement in those with less advanced fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Zanaga

Vigani

Angerami

et al. 2017

Braz J Med Biol Res

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Recurrent hepatitis C after orthotopic liver transplantation (OLT) is universal and can lead to graft failure and, consequently, reduced survival. Hepatitis C treatment can be used to prevent these detrimental outcomes. The aim of this study was to describe rates of hepatitis C recurrence and sustained virological response (SVR) to interferon-based treatment after OLT and its relationship to survival and progression of liver disease through retrospective analysis of medical records of 127 patients who underwent OLT due to cirrhosis or hepatocellular carcinoma secondary to chronic hepatitis C between January 2002 and December 2013. Fifty-six patients were diagnosed with recurrent disease, 42 started interferon-based therapy and 37 completed treatment. Demographic, treatment- and outcome-related variables were compared between SVR and non-responders (non-SVR). There was an overall 54.1% SVR rate with interferon-based therapies. SVR was associated with longer follow-up after treatment (median 66.5 vs 37 months for non-SVR, P=0.03) and after OLT (median 105 vs 72 months, P=0.074), and lower rates of disease progression (15 vs 64.7%, P=0.0028) and death (5 vs 35.3%, P=0.033). Regardless of the result of therapy (SVR or non-SVR), there was a significant difference between treated and untreated patients regarding the occurrence of death (P<0.001) and months of survival (P<0.001). Even with suboptimal interferon-based therapies (compared to the new direct-acting antivirals) there is a 54.1% SVR rate to treatment. SVR is associated with improved survival and reduced risks of clinical decompensation, loss of the liver graft and death.

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Sofosbuvir-Based Antiviral Therapy Is Highly Effective In Recurrent Hepatitis C in Liver Transplant Recipients

Cited by 33 publications

References 17 publications

Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

Fibrosing cholestatic hepatitis C in post-transplant adult recipients of liver transplantation

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

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