Efficacy and safety of direct-acting antiviral therapy in previous hard-to-treat patients with recurrent hepatitis C virus infection after liver transplantation: a real-world cohort

Drug Des Devel Ther. 2017 Jul 12:11:2131-2138. doi: 10.2147/DDDT.S139837. eCollection 2017.

Abstract

Background: Recurrent hepatitis C virus (HCV) infection after liver transplantation (LT) has been a frequent and relevant problem in the past two decades. This analysis evaluated the efficacy and safety of new interferon (IFN)-free direct-acting antiviral (DAA) therapies in a large real-world cohort of HCV patients after LT.

Methods: We retrospectively analyzed a cohort of 157 patients infected with HCV who underwent deceased donor LT between 1997 and 2014. Patient survival, outcome, and side effects of antiviral therapy were assessed.

Results: Survival with recurrent HCV genotype 1 (GT1) infection was inferior to other HCV GTs (P=0.01). The overall sustained virological response (SVR) rate with new DAA therapy was 94.6% (n=37). Patients with both GT1 and other GTs reached SVR rates >90%. We noticed a few side effects, mainly caused by ribavirin, and only one discontinuation in DAA-treated patients.

Conclusion: DAA therapy was effective and safe in previous hard-to-treat patients after LT in this real-world cohort.

Keywords: DAA; HCV; SVR; liver transplantation; reinfection; sustained virological response.

MeSH terms

  • Aged
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Hepacivirus / drug effects
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / prevention & control
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antiviral Agents