Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Friday, 08 / 18 / 2017

Articles

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C

ORIGINAL ARTICLE

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C

Sammy Saab*1,2, Justin Rheem3, Melissa A. Jimenez2, Tiffany M. Fong2, Michelle H. Mai2, Caterina A. Kachadoorian2, Negin L. Esmailzadeh2, Sherona N. Bau1,2, Susan Kang1,2, Samantha D. Ramirez2, Jonathan Grotts4, Gina Choi1,2, Francisco A. Durazo1,2, Mohammed M. El-Kabany1,2, Steven-Huy B. Han1,2 and Ronald W. Busuttil1,2

1Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA
2Departments of Surgery at the University of California at Los Angeles, Los Angeles, California, USA
3Department of Medicine at Harbor-University of California at Los Angeles Medical Center, Torrance, California, USA
4Department of Biostatistics at the University of California at Los Angeles, Los Angeles, California, USA

*Correspondence to: Sammy Saab, Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA. Tel: +1-310 206 6705, Fax: +1-310-206-4197, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(2):101-108 DOI: 10.14218/JCTH.2016.00070
Received: November 28, 2016 Accepted: April 3, 2017 Published online: May 14, 2017

Abstract

Background and Aims: Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality.

Methods: We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C.

Results: Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks. The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months. The mean (± SD) age of the cohort was 63 (±8.6) years old. Most recipients were male (70%). Baseline alanine transaminase, total bilirubin, and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126) mg/dL, 0.8 (±1.3) U/L, and 8,010,421.9 (±12,420,985) IU/mL, respectively. Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects, with 4 of those being anemia complications. No recipient discontinued the ledipasvir/sofosbuvir. Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy, and all recipients had complete viral suppression at the end of therapy. The sustained viral response at 12 weeks after completion of therapy was 94%.

Conclusion: Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT. Anemia is not uncommon in LT recipients receiving ribavirin.

Keywords

Liver transplantation, Immunosuppressant, Hepatitis C, Direct-acting agents, Sustained viral response

 

Journal of Clinical and Translational Hepatology 2017 vol. 5 Html ] [ PDF Full-text ]

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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