Triple therapy using direct-acting agents for recurrent hepatitis C after liver transplantation: a single-center experience.

Abstract:

BACKGROUND:Hepatitis C viral graft reinfection is almost a universal event after liver transplantation with consequent disease progression. METHODS:We applied triple therapy (n = 21) with the use of telaprevir (TVR; n = 12) or simeprevir (SVR; n = 9). RESULTS:TVR was given at the dose 1,500 mg daily (n = 11) with reduced dose of cyclosporine at 25% to 50%, and SVR was given at the dose 100 mg daily with unadjusted cyclosporine, followed by 12 weeks of dual therapy. The early viral response was achieved in 91.7% (n = 11), end of treatment response rate was 91.7% (n = 11), and sustained viral response rate was 83.3% (n = 10) in the TVR group, and respective rates were 88.9% (n = 8), 77.8% (n = 7), and 77.8% (n = 7) in the SVR group. Although granulocyte colony-stimulating factor was not given in the patients with triple therapy, blood transfusion was performed in 7 cases (58.3%) in the TVR group and 1 case (11.1%) in the SVR group. Interferon-mediated graft dysfunction was observed in 4 cases (33.3%) in the TVR group and 3 cases (33.3%) in the SVR group, respectively. The cumulative viral clearance rates in triple (n = 21) and dual (n = 105) therapy were 95.0% and 18.1% at 12 weeks, and 95.0% and 40.0%, respectively, at 24 weeks (P < .01). CONCLUSIONS:Although careful monitoring for possible adverse events is required during treatment, triple therapy with the use of direct-acting agents are very effective in treating hepatitis C after liver transplantation.

journal_name

Transplant Proc

authors

Ikegami T,Yoshizumi T,Soejima Y,Harimoto N,Itoh S,Takeishi K,Uchiyama H,Kawanaka H,Yamashita YI,Tsujita E,Harada N,Oki E,Saeki H,Kimura Y,Shirabe K,Maehara Y

doi

10.1016/j.transproceed.2014.10.058

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

730-2

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(15)00146-3

journal_volume

47

pub_type

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