scholarly journals Evaluation of Different Regimens of New Direct Acting Antiviral drugs (DAAs) for treatment of Recurrent Hepatitis C Virus Infection after Liver Transplantation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Reda ◽  
M M Bahaa ◽  
I F Montasser ◽  
M A Shamkh
Keyword(s):  
Liver Transplantation ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
Transplant Recipients ◽  
Hepatitis C Virus Infection ◽  
Inclusion Criteria ◽  
Donor Liver Transplantation ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C ◽  
Liver Transplant Recipients

Abstract Aim of the work To compare between different available regimens of DAAs (sofosbuvir/ daclatasvir and sofosbuvir / ledipasvir) regarding the efficacy and safety for treatment of compensated recurrent hepatitis C Virus infection after liver transplantation in Egyptian patients and to study the correlation between sofosbuvir / daclatasvir and sofosbuvir / ledipasvir and post-transplant complications. Background Liver transplantation is the only curative treatment for ESLD and HCC. Liver disease resulting from chronic HCV infection is the leading indication for liver transplantation. For patients with detectable HCV-RNA levels at the time of transplantation, postoperative recurrence of HCV infection was “immediate and universal.” Recurrent HCV infection follows an aggressive course and retransplantation frequently is associated with a poor outcome. Patients and Methods This prospective study was conducted on recipients, who underwent living donor liver transplantation in Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams University Specialized Hospital (ASUSH), Cairo, Egypt between June, 2016 and May, 2017. Data of the recipients, who underwent living donor liver transplantation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and received antiviral treatment were followed up monthly during their treatment and after finishing treatment for at least 3 months. Results Treatment of HCV recurrence in liver transplant recipients with SOF+DCV+RBV or SOF/LDV+RBV seems to confer high rates of SVR. There was no difference between both regimens regarding adverse events. Prolonged treatment of HCV recurrence after LDLT (24 weeks) was significantly associated with a higher SVR (P = 0.035). Conclusion Adding RBV to antiviral regimens in the treatment of HCV recurrence in liver transplant recipients doesn’t seem to add to the efficacy of DAAs. Adherence to prolonged course of antiviral treatment (6 months) when treating HCV recurrence post liver transplantation seems to be associated with higher rates of SVR than shorter course (3 months) with no increase in the incidence of adverse events or rejection episodes.

scholarly journals Outcome of early vs. deferred antiviral treatment for recurrent hepatitis C in liver transplant recipients

2014 ◽  
Vol 13 (2) ◽  
pp. 219-230
Author(s):  
Isabel Campos-Varela ◽  
Juan Ignacio Esteban ◽  
Marta Bes ◽  
Cristina Dopazo ◽  
Helena Allende ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Antiviral Treatment ◽  
Transplant Recipients ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C ◽  
Liver Transplant Recipients

scholarly journals Anemia in liver transplant recipients undergoing antiviral treatment for recurrent hepatitis C

2007 ◽  
Vol 13 (7) ◽  
pp. 1032-1038 ◽  
Author(s):  
Sammy Saab ◽  
Mina K. Oh ◽  
Ayman B. Ibrahim ◽  
Francisco Durazo ◽  
Steven Han ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Antiviral Treatment ◽  
Transplant Recipients ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C ◽  
Liver Transplant Recipients

Treatment of recurrent hepatitis C virus infection after liver transplantation

2007 ◽  
Vol 148 (40) ◽  
pp. 1875-1881
Author(s):  
Gabriella Lengyel ◽  
Zsolt Tulassay
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Hepatitis A ◽  
Hepatitis C Virus Infection ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C

A májtranszplantációk fő indikációja a hepatitis C-fertőzés következtében kialakult végstádiumú C-cirrhosis hepatitis. A transzplantáció után a HCV-fertőzés visszatérése általános, a rekurráló C-hepatitis progresszív betegség, kezelés nélkül az immunszuppresszió mellett öt éven belül a betegek 20%-ában cirrhosist okoz. A visszatérő HCV-fertőzés kezelése a transzplantált betegek túlélésének legfontosabb meghatározó tényezője. A szerzők az irodalmi adatok és saját tapasztalatuk alapján áttekintik a kiújuló HCV-fertőzés kimenetelét befolyásoló tényezőket. Részletezik az immunszuppresszív kezelés hatását, a megfelelő immunszuppresszív gyógyszer kiválasztásának fontosságát. Áttekintik a visszatérő C-hepatitis diagnózisának fő szempontjait, hangsúlyozzák a protokoll szerint végzett májbiopsziák meghatározó szerepét a diagnózisban, a patológus, a hepatológus és a sebész szoros együttműködését. Ismertetik a várólistán lévő betegek kezelésével szerzett tapasztalatokat, a kiújult krónikus hepatitis korai preemptív kezelési eredményeit és a már szövettani elváltozásban megnyilvánuló krónikus C-hepatitis kezelési lehetőségeit és eredményeit. A transzplantáción átesett betegek krónikus C-hepatitisének jelenleg elfogadott gyógyszere a pegilált interferon és ribavirin kombinációja. Ezzel a terápiával a betegek 20–50%-ában tartós vírusmentesség érhető el. A vírusmentes betegekben egyértelműen csökken a májszövetben a gyulladásos aktivitás, javul a szövettani aktivitási index. A kezelés fibrózisgátló hatására is vannak adatok, ezek további megerősítése azonban multicentrikus vizsgálatokat igényel. A legtöbb tanulmány nem igazolja a korai, szövettani eltérés nélküli antivirális kezelés előnyét. Ebben a betegcsoportban a kezelés gyakori mellékhatása az anémia és a neutropenia, ezért ajánlott az erythropoetin és a granulocyta-stimuláló faktor adása. A rekurráló C-hepatitisben szenvedő betegek optimális kezelése, a pegilált interferon és ribavirin dózisának meghatározása, a terápia időtartama, a mellékhatások csökkentése, a nagyobb arányú gyógyulás elérése további vizsgálatokat, klinikai tanulmányokat tesz szükségessé.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

Ledipasvir/Sofosbuvir for Recurrent Hepatitis C in Liver Transplant Recipients: A Real-Life Spanish Multicentre Experience

2016 ◽  
Vol 64 (2) ◽  
pp. S794-S795 ◽  
Author(s):  
M. Prieto ◽  
I. Fernández ◽  
M.-C. Londoño ◽  
M. Abradelo ◽  
J.M. Pascasio ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Real Life ◽  
Transplant Recipients ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C ◽  
Liver Transplant Recipients
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