Abstract:
AIM:To analyze the safety and efficiency of direct-acting antiviral (DAA) regimens in liver-transplanted patients with hepatitis C virus (HCV) reinfection. METHODS:Between January 2014 and December 2016, 39 patients with HCV reinfection after liver transplantation were treated at our tertiary referral center with sofosbuvir (SOF)-based regimens, including various combinations with interferon (IFN), daclatasvir (DAC), simeprivir (SIM) and/or ledipasvir (LDV). Thirteen patients were treated with SOF + IFN ± RBV. Ten patients were treated with SOF + DAC ± RBV. Fiveteen patients were treated with fixed-dose combination of SOF + LDV ± RBV. One patient was treated with SOF + SIM + RBV. Three patients with relapse were retreated with SOF + LDV + RBV. The treatment duration was 12-24 wk in all cases. The decision about the HCV treatment was made by specialists at our transplant center, according to current available or recommended medications. RESULTS:The majority of patients were IFN-experienced (29/39, 74.4%) and had a history of hepatocellular carcinoma (26/39, 66.7%) before liver transplantation. Sustained virological response at 12 wk (SVR12) was achieved in 10/13 (76.9%) of patients treated with SOF + IFN ± RBV. All patients with relapse were treated with fixed-dose combination of SOF + LDV + RBV. Patients treated with SOF + DAC + RBV or SOF + LDV + RBV achieved 100% SVR12. SVR rates after combination treatment with inhibitors of the HCV nonstructural protein (NS)5A and NS5B for 24 wk were significantly higher, as compared to all other therapy regimens (P = 0.007). Liver function was stable or even improved in the majority of patients during treatment. All antiviral therapies were safe and well-tolerated, without need of discontinuation of treatment or dose adjustment of immunosuppression. No serious adverse events or any harm to the liver graft became overt. No patient experienced acute cellular rejection during the study period. CONCLUSION:Our cohort of liver-transplanted patients achieved high rates of SVR12 after a 24-wk course of treatment, especially with combination of NS5A and NS5B inhibitors.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Rupp C,Hippchen T,Neuberger M,Sauer P,Pfeiffenberger J,Stremmel W,Gotthardt DN,Mehrabi A,Weiss KHdoi
10.3748/wjg.v24.i12.1353subject
Has Abstractpub_date
2018-03-28 00:00:00pages
1353-1360issue
12eissn
1007-9327issn
2219-2840journal_volume
24pub_type
杂志文章abstract:AIM:To evaluate the value of ABC (D) stratification [combination of serum pepsinogen and Helicobacter pylori (H. pylori) antibody] of patients with gastric cancer. METHODS:Ninety-five consecutive patients with gastric cancer were enrolled into the study. The serum pepsinogen I (PG I)/pepsinogen II (PG II) and H. pylor...
journal_title:World journal of gastroenterology
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doi:10.3748/wjg.v17.i43.4793
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journal_title:World journal of gastroenterology
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doi:10.3748/wjg.v12.i48.7779
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doi:10.3748/wjg.v4.i5.437
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doi:10.3748/wjg.v12.i45.7329
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.15.1315
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journal_title:World journal of gastroenterology
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更新日期:2019-10-14 00:00:00
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doi:10.3748/wjg.v21.i24.7443
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
doi:10.3748/wjg.v13.i35.4690
更新日期:2007-09-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2005-03-07 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2019-06-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2018-11-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2015-03-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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pub_type: 社论,评审
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