Clinical efficacy of Direct Acting Antivirals (DAAs) for Treatment of Recurrent Hepatitis C Virus infection After Liver Transplantation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Saleh Mohamed Ahmed Ismail ◽  
Osama Aboelfotoh El Sayed ◽  
Mohamed Mohamed Bahaa El-Din ◽  
Wael Ahmed Yousry ◽  
Maha Mohsen Kamal El-Din ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Failure ◽  
Hcv Infection ◽  
Post Transplantation ◽  
Recurrent Hepatitis ◽  
History Of ◽  
Recurrent Hepatitis C ◽  
Hcc Recurrence

Abstract BACKGROUND & AIMS Recurrent hepatitis C virus (HCV) infection of transplanted liver allografts is universal in patients with detectable HCV viremia at the time of transplantation. Directacting antiviral (DAA) therapy has been adopted as the standard of care for recurrent HCV infection in the post-transplant setting. However, there are insufficient data regarding its efficacy in liver transplant (LT) recipients with a history of hepatocellular carcinoma (HCC), and the risk of HCC recurrence after DAA therapy is unknown. In this study, we aimed to demonstrate predictors of DAA treatment failure and HCC recurrence in LT recipients. METHODS A total of 106 LT recipients given DAAs for recurrent HCV infection from 2015 to 2019 were identified (68 with and 38 without HCC). Descriptive statistics and logistic regression models were used to estimate the multivariate odds ratios and respective 95% confidence intervals for predictors of treatment failure and HCC recurrence. RESULTS Six patients (6%) experienced DAA therapy failure and 100 (94%) had a sustained virologic response at follow-up week 12 (SVR12). A high alanine transaminase level >35 U/L at treatment week 4 was a significant predictor of treatment failure. DAA failure at follow-up week 12 was significantly associated with post-transplantation HCC recurrence, (odds ratio, 10.6 [95% confidence interval, 1.0-121.6]; P = .05). CONCLUSIONS DAAs are effective and safe in the treatment of recurrent HCV infection in LT recipients with history of HCC. Lack of SVR12 is a predictor of post-transplantation HCC recurrence.

scholarly journals The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients

2004 ◽  
Vol 18 (suppl c) ◽  
pp. 19C-26C ◽  
Author(s):  
Paul J Marotta
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Patient Population ◽  
Wide Spectrum ◽  
Early Recurrence ◽  
Recurrent Hepatitis ◽  
Significant Toxicity ◽  
History Of ◽  
Recurrent Hepatitis C ◽  
Liver Transplant Recipients

Hepatitis C virus (HCV) has become the leading indication for liver transplantation (LT) worldwide. Short-term graft and patient survival after LT in these individuals is comparable with other indications for LT. There is, however, a disturbing trend for decreased survival over the longer term. The natural history of HCV infection after LT is evolving. Its early recurrence and the wide spectrum of recurrent disease is recognized, from minimal histological and clinical disease to very aggressive forms of hepatic damage such as fibrosing cholestatic hepatitis. There is growing concern that recurrent HCV is becoming more aggressive. Although many factors have been implicated, the causes have not been fully elucidated. Interferon-based antiviral therapy is challenging to use in this patient population because of significant toxicity. Nevertheless, these agents have some efficacy, and pegylated interferons, which are now being used more frequently, achieve superior response rates. The role of liver retransplantation in this patient population is controversial, because of both a reduced survival rate and an overall shortage of organ donors. The present review discusses the challenges that occur in LT recipients with HCV.

Retransplant of the liver (RLT) in recurrent hepatitis C virus (HCV)infection: Retrospective multicentric study

2000 ◽  
Vol 32 ◽  
pp. 55
Author(s):  
R. Bároena ◽  
D. Pares ◽  
L. Grande ◽  
M. Prieto ◽  
C. Barrios ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Multicentric Study ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C

scholarly journals Sofosbuvir and daclatasvir are safe and effective in treatment of recurrent hepatitis C virus in Egyptian patients underwent living donor liver transplantation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Osama Aboelfotoh Aly ◽  
Wael Ahmed Yousry ◽  
Nahla Mohamed Teama ◽  
Eman Mohammed Shona ◽  
Ahmed Mohamed ElGhandour
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Recurrent Hepatitis ◽  
Recurrent Hepatitis C

Abstract Background Liver transplant population has been considered as a special population in the treatment of hepatitis C virus infection, not only because of lower sustained virological response (SVR) rates in comparison with pretransplant setting, but also for other aspects (i.e., immunosuppressive therapy, renal function, drug–drug interactions). We aimed to evaluate the efficacy and safety of the combined treatment with sofosbuvir and daclatasvir with or without ribavirin in liver transplant recipients with recurrent hepatitis C following transplantation and screening for the development of hepatocellular carcinoma during treatment, after the end of treatment, or during follow-up. This multicenteric prospective study was conducted in Egypt. This study included 40 patients who underwent living donor liver transplantation that started treatment at least 3 months following transplantation. All participants received 400 mg sofosbuvir once daily plus daclatasvir 60 mg daily ± ribavirin. Treatment lasted for up to 24 weeks, and participants were followed up as outpatients monthly for 12 and 24 weeks and 36 weeks post-treatment to determine sustained virological response (SVR12 and SVR24), considered to be a cure and detection of any changes in tumor markers or radiological imaging during follow-up. Results In the current study, 40 patients (100%) have good response to treatment during treatment and during follow-up (SVR 12 was 100%). No abnormal side effects to treatment were detected; also, no drug–drug interactions were noted during the treatment. Conclusions Treatment of HCV after living donor liver transplantation with combined sofosbuvir and daclatasvir is safe and well-tolerated and provides high rates of SVR.

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 Natural History of Hepatitis C Virus among Apparently Normal Schoolchildren: Follow‐up after 7 Years

2003 ◽  
Vol 49 (6) ◽  
pp. 384-385 ◽  
Author(s):  
Azza El‐Sherbini ◽  
Wafaa Hassan ◽  
Mohamad Abdel‐Hamid ◽  
Ahmad Naeim
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Natural History ◽  
History Of

Chronic Ductopenic Rejection in Patients With Recurrent Hepatitis C Virus Treated With Pegylated Interferon Alfa-2a and Ribavirin

2007 ◽  
Vol 84 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Carmen M. Stanca ◽  
M Isabel Fiel ◽  
Nickolas Kontorinis ◽  
Kaushik Agarwal ◽  
Sukru Emre ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pegylated Interferon ◽  
Interferon Alfa ◽  
Recurrent Hepatitis ◽  
Pegylated Interferon Alfa ◽  
Recurrent Hepatitis C
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