Triple therapy using direct-acting agents for recurrent hepatitis C after liver transplantation: a single-center experience.

Abstract

BACKGROUND:

Hepatitis C viral graft reinfection is almost a universal event after liver transplantation with consequent disease progression.

METHODS:

We applied triple therapy (n = 21) with the use of telaprevir (TVR; n = 12) or simeprevir (SVR; n = 9).

RESULTS:

TVR was given at the dose 1,500 mg daily (n = 11) with reduced dose of cyclosporine at 25% to 50%, and SVR was given at the dose 100 mg daily with unadjusted cyclosporine, followed by 12 weeks of dual therapy. The early viral response was achieved in 91.7% (n = 11), end of treatment response rate was 91.7% (n = 11), and sustained viral response rate was 83.3% (n = 10) in the TVR group, and respective rates were 88.9% (n = 8), 77.8% (n = 7), and 77.8% (n = 7) in the SVR group. Although granulocyte colony-stimulating factor was not given in the patients with triple therapy, blood transfusion was performed in 7 cases (58.3%) in the TVR group and 1 case (11.1%) in the SVR group. Interferon-mediated graft dysfunction was observed in 4 cases (33.3%) in the TVR group and 3 cases (33.3%) in the SVR group, respectively. The cumulative viral clearance rates in triple (n = 21) and dual (n = 105) therapy were 95.0% and 18.1% at 12 weeks, and 95.0% and 40.0%, respectively, at 24 weeks (P < .01).

CONCLUSIONS:

Although careful monitoring for possible adverse events is required during treatment, triple therapy with the use of direct-acting agents are very effective in treating hepatitis C after liver transplantation.

• Authors: T Ikegami, T Yoshizumi, Y Soejima, N Harimoto, S Itoh, K Takeishi, H Uchiyama, H Kawanaka, Y-I Yamashita, E Tsujita, N Harada, E Oki, H Saeki, Y Kimura, K Shirabe, Y Maehara
• Journal: Transplantation proceedings (Transplant Proc) Vol. 47 Issue 3 Pg. 730-2 (Apr 2015) ISSN: 1873-2623 [Electronic] United States
• PMID: 25891720 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Oligopeptides
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• telaprevir
• Simeprevir
• peginterferon alfa-2b
• peginterferon alfa-2a

Topics

• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Combined Modality Therapy
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Hepatitis C, Chronic (drug therapy, surgery)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Liver Transplantation
• Male
• Middle Aged
• Oligopeptides (therapeutic use)
• Polyethylene Glycols (therapeutic use)
• Recombinant Proteins (therapeutic use)
• Recurrence
• Ribavirin (therapeutic use)
• Simeprevir (therapeutic use)
• Treatment Outcome