Treatment of severe recurrent hepatitis C after liver transplantation in HIV infected patients using sofosbuvir‐based therapy

Abstract

Sofosbuvir-based regimens are safe, well-tolerated and provide high rates of SVR in HCV-HIV co-infected patients with severe recurrence after-liver transplant.

Successful Pre- and Posttransplant Sofosbuvir-Based Anti-Hepatitis C Virus Treatment in Persons Living With Human Immunodeficiency Virus Infection

“…Data of 13 patients treated pre-OLT have been published: SVR was observed in 9 of 10 patients treated with optimal therapy (90%) and in 1 of 3 (33.3%) patients treated with SOF and RBV. Six small series reported the data of 48 patients treated post-OLT: the SVR12 rate was 90%, but it topped at 100% when evaluating only the 28 patients treated with optimal regimens [5–10]. These and our results confirm the data observed in HCV-monoinfected individuals in the same settings [4].…”

“…In contrast, sofosbuvir (SOF)-based therapies have showed high efficacy and tolerability in both OLT candidates and recipients [4]. So far, small series data in HIV/HCV-coinfected persons have been published, cumulatively reporting treatment in 13 OLT candidates and 48 recipients [5–10]. The aim of this study was to assess the impact of SOF-based anti-HCV, all oral treatment on OLT in PLWHIV.…”

Strategies to improve outcomes for hepatitis C virus/human immunodeficiency virus coinfected liver transplant candidates

“…In this issue of Liver Transplantation , Araiz et al report an intent‐to‐treat survival analysis (ITTA) of HCV/HIV‐coinfected candidates listed for liver transplantation. This valuable analysis confirms previous US, Spanish, and French series reporting inferior outcomes following liver transplantation in the HCV/HIV coinfected liver recipient compared to mono‐infected HIV‐positive recipients. Most notably, this ITTA confirms that HCV/HCV coinfection is associated with a higher mortality on the waiting list than is observed in HCV mono‐infected candidates.…”

“…It is important to note that the ITTA was done in an era predating the introduction of the new direct‐acting agents effective in curing HCV. Treatment with these newer agents will undoubtedly improve survival in the HCV/HIV‐coinfected patients on the waiting list and following transplantation . With effective HCV clearance, it is possible that the MELD score will be a more accurate predictor of survival on the waiting list for the HCV/HIV‐coinfected recipient.…”

Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study

“…Nevertheless, data on the efficacy and safety of DAAs in HCV/HIV‐coinfected LT recipients are limited to case series and individual case reports. The largest series was published by Campos‐Varela et al, who evaluated the outcome of a sofosbuvir (SOF)‐based compassionate use program in HCV/HIV‐coinfected LT recipients. The authors found that 20 patients with early recurrence of severe HCV infection or cirrhosis received SOF‐based antiviral therapy.…”