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Successful Treatment of Chronic Hepatitis C Virus Infection With Sofosbuvir and Ledipasvir in Renal Transplant Recipients
- Source :
- Transplantation. 101(5)
- Publication Year :
- 2016
-
Abstract
- Background Treatment of chronic hepatitis C virus (HCV) infection after renal allograft transplantation has been an obstacle because of contraindications associated with IFN-based therapies. Direct-acting antiviral agents are highly efficient treatment options that do not require IFN and may not require ribavirin. Therefore, we assessed the efficacy and safety of sofosbuvir and ledipasvir in renal transplant patients with chronic HCV infection. Methods Fifteen renal allograft recipients with therapy-naive HCV genotype (GT) 1a, 1b, or 4 were treated with the combination of sofosbuvir and ledipasvir without ribavirin for 8 or 12 weeks. Clinical data were retrospectively analyzed for viral kinetics and for renal and liver function parameters. Patients were closely monitored for trough levels of immunosuppressive agents, laboratory values, and potential adverse effects. Results Ten patients (66%) exhibited a rapid virologic response within 4 weeks (HCV GT1a, n = 4; HCV GT1b, n = 6). The other 5 patients exhibited a virologic response within 8 (HCV GT 1b, n = 4) or 12 weeks (HCV GT4, n = 1). One hundred percent of patients exhibited sustained virologic response at week 12 after the end of treatment. Clinical measures of liver function improved substantially for all patients. Adverse events were scarce; renal transplant function and proteinuria remained stable. Importantly, dose adjustments for tacrolimus were necessary for maintaining sufficient trough levels. Conclusions The described regimen appears to be safe and effective for patients after renal transplant and is a promising treatment regimen for eradicating HCV in this patient population.
- Subjects :
- Ledipasvir
Adult
Male
medicine.medical_specialty
Sofosbuvir
030232 urology & nephrology
Medizin
Gastroenterology
Antiviral Agents
Drug Administration Schedule
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Postoperative Complications
Internal medicine
medicine
Humans
Rapid Virologic Response
Kidney transplantation
Aged
Retrospective Studies
Transplantation
Fluorenes
business.industry
Ribavirin
Hepatitis C
Hepatitis C, Chronic
Middle Aged
medicine.disease
Kidney Transplantation
Regimen
Treatment Outcome
chemistry
Immunology
030211 gastroenterology & hepatology
Benzimidazoles
Drug Therapy, Combination
Female
Liver function
business
medicine.drug
Follow-Up Studies
Subjects
Details
- ISSN :
- 15346080
- Volume :
- 101
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....25d937af48073ceb23e7a953dd61e7d2