Impact of Sofosbuvir‐Based Therapy on Liver Transplant Candidates with Hepatitis C Virus Infection.

Background: Sofosbuvir use in patients with decompensated cirrhosis may be associated with reduced liver transplant waitlist mortality and reduced need for transplant. Methods: Data from the Scientific Registry of Transplant Recipients were linked with a national database of pharmacy claims. All adult patients on the liver transplant waitlist on January 1, 2014, or added to the list during 2014, with hepatitis C virus as reason for listing were identified (2009 patients). A subgroup of 1093 unique patients had consistent pharmacy claim capture and observations. We compared patients who were and were not treated with all sofosbuvir‐based regimens. Results: During the study period, 154 patients received sofosbuvir‐based regimens. These patients had lower model for end‐stage liver disease scores and significantly longer waiting times. We found a trend toward significance for more sofosbuvir‐treated than untreated patients being removed from the waitlist due to improved condition (4.54% vs 3.19%, p=0.03). In a propensity score‐adjusted analysis, sofosbuvir‐treated patients were less likely to undergo transplant (hazard ratio 0.57, 95% confidence interval 0.37–0.89, p=0.01). Conclusion: During the study period reflecting early sofosbuvir use, few liver transplant candidates received sofosbuvir. Use was associated with lower incidence of transplant and a trend toward more waitlist removals due to improved condition. [ABSTRACT FROM AUTHOR]