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• W2979269016 abstract "Introduction: Recurrent hepatitis C (HCV) is universal in the presence of active viral replication at the time of liver transplant (LT). Disease progression is faster in infected allografts when compared with native liver, with histologic hepatitis developing in 75% at 6 months and cirrhosis in 30% within 5 years of LT. Although direct acting anti-virals (DAA) have significantly improved sustained virologic response (SVR) rates in treating chronic HCV, their efficacy in LT recipients warrants a closer analysis. Most recently, SOLAR-2 showed 95% SVR12 for non-cirrhotic or compensated LT patients with 12 weeks of ledipasvir/sofosbuvir. We aim to assess SVR, compliance and adverse events of interferon (IFN)-free regimens in LT recipients with HCV recurrence. Methods: We performed a single-center observational series from January 1, 2014 onwards. LT recipients with recurrent HCV who received a minimum of 12 weeks of IFN-free regimen were included. HCV viral loads were trended during and after therapy completion. Drug compliance and adverse events were assessed. The control group included recipients who had received IFN-based treatment. Groups were compared using a Fisher's exact test. Results: Twenty-three patients completed 12 weeks of DAA-therapy and 12 completed IFN-based regimens (Figure 1). In the DAA group 18 had genotype (GT) 1, one GT2, one GT3, two GT4 and one mixed GT infection. There was biopsy-proven cirrhosis in 78 percent (18/23). SVR12 was achieved in 62 percent (8/13) of patients who had completed DAA-therapy and had available SVRs compared to 42 percent (5/12) of those who had IFN-based regimens only (p=0.434). Of the 23 who received DAAs, 8 had failed post-LT IFN therapy for a cumulative SVR12 of 25 percent (5/20) with IFN (p=0.067). Three of the five that failed to achieve SVR12 with DAAs had biopsy-proven cirrhosis. End-treatment response (ETR) was achieved in 82 percent (18/22) after DAA therapy including 76 percent (13/17) of genotype 1 patients. Regimens including ledipasvir had ETR in all 6 patients compared to 75 percent (12/16) who did not (p=0.541) (Figure 2). One patient discontinued ribavirin due to anemia.Figure 1Figure 2Conclusion: SVRs in the LT recipients using DAAs are improved from IFN-based regimens. The use of ledipasvir has improved results regardless of genotype. Added benefit of these regimens includes limited number of adverse events. Prospective studies are required to further define treatment in this unique population." @default.
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• W2979269016 date "2015-10-01" @default.
• W2979269016 modified "2023-09-27" @default.
• W2979269016 title "Evaluation of Interferon-Free Hepatitis C Treatment Regimens in Liver Transplant Recipients: Our Experience" @default.
• W2979269016 doi "https://doi.org/10.14309/00000434-201510001-02170" @default.
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