Treating fibrosing cholestatic hepatitis C with sofosbuvir and ribavirin: a matched analysis.

Abstract

BACKGROUND:

Fibrosing cholestatic hepatitis (FCH) is an uncommon but potentially fatal complication of recurrent hepatitis C (HCV) in liver transplant recipients.

METHODS:

We matched the treatment outcomes of 10 liver transplant recipients who developed FCH with those of 10 recipients with recurrent HCV without FCH treated with sofosbuvir and ribavirin.

RESULTS:

Baseline mean alanine transaminase, aspartate transaminase, alkaline phosphatase, and total bilirubin were 186 U/L, 197 U/L, 243 U/L, and 6.7 mg/dL, respectively, in the FCH recipients and 82 U/L, 60 U/L, 110 U/L, and 0.99 mg/dL, respectively, in non-FCH recipients. The sustained viral response in FCH and non-FCH recipients was 40% and 80%, respectively. One-yr patient and graft survival rates were 90% and 80%, respectively, in FCH recipients, and 100% in non-FCH recipients. Seven FCH and six non-FCH recipients were treated for anemia with blood transfusion and/or erythropoietin growth factors.

CONCLUSION:

Our results suggest that the use of sofosbuvir and ribavirin is effective and tolerable in liver transplant recipients treated for recurrent FCH. There is a trend of lower sustained viral response, patient survival, and graft survival in the FCH recipients.

• Authors: Sammy Saab, Melissa Jimenez, Sherona Bau, Tyralee Goo, Difan Zhao, Francisco Durazo, Steven Han, Mohammed El Kabany, Fady Kaldas, Myron J Tong, Ronald W Busuttil
• Journal: Clinical transplantation (Clin Transplant) Vol. 29 Issue 9 Pg. 813-9 (Sep 2015) ISSN: 1399-0012 [Electronic] Denmark
• PMID: 26147216 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antiviral Agents
• Ribavirin
• Sofosbuvir

Topics

• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Case-Control Studies
• Cholestasis, Intrahepatic (drug therapy, etiology, mortality)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Graft Survival
• Hepatitis C, Chronic (drug therapy, mortality, surgery)
• Humans
• Liver Cirrhosis (drug therapy, etiology, mortality)
• Liver Transplantation
• Male
• Matched-Pair Analysis
• Middle Aged
• Postoperative Complications (drug therapy, mortality)
• Recurrence
• Retrospective Studies
• Ribavirin (therapeutic use)
• Sofosbuvir (therapeutic use)
• Treatment Outcome