Background and Aims:Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality.Methods:We retrospectively evaluated the safe...Background and Aims:Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality.Methods:We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C.Results:Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks.The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months.The mean (± SD) age of the cohort was 63 (±8.6) years old.Most recipients were male (70%).Baseline alanine transaminase,total bilirubin,and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126)mg/dL,0.8 (±1.3) U/L,and 8,010,421.9 (±12,420,985)IU/mL,respectively.Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects,with 4 of those being anemia complications.No recipient discontinued the ledipasvir/sofosbuvir.Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy,and all recipients had complete viral suppression at the end of therapy.The sustained viral response at 12 weeks after completion of therapy was 94%.Conclusion:Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT.Anemia is not uncommon in LT recipients receiving ribavirin.展开更多
文摘Background and Aims:Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality.Methods:We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C.Results:Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks.The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months.The mean (± SD) age of the cohort was 63 (±8.6) years old.Most recipients were male (70%).Baseline alanine transaminase,total bilirubin,and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126)mg/dL,0.8 (±1.3) U/L,and 8,010,421.9 (±12,420,985)IU/mL,respectively.Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects,with 4 of those being anemia complications.No recipient discontinued the ledipasvir/sofosbuvir.Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy,and all recipients had complete viral suppression at the end of therapy.The sustained viral response at 12 weeks after completion of therapy was 94%.Conclusion:Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT.Anemia is not uncommon in LT recipients receiving ribavirin.
