BACKGROUND Direct-acting antiviral(DAA)therapy regimens are highly effective at eliminating hepatitis C virus(HCV)infection but rates of sustained virologic response(SVR)are lower in patients with decompensated cirrho...BACKGROUND Direct-acting antiviral(DAA)therapy regimens are highly effective at eliminating hepatitis C virus(HCV)infection but rates of sustained virologic response(SVR)are lower in patients with decompensated cirrhosis or hepatocellular carcinoma.Since many of these patients will be referred for liver transplant,they will require retreatment after transplantation.Sofosbuvir/velpatasvir/voxilaprevir(SOF/VEL/VOX)is recommended by guidelines as the preferred regimen to treat HCV in DAA-experienced patients following liver transplant however there is limited data.CASE SUMMARY We present the cases of six liver transplant recipients who had previous treatment failure with sofosbuvir-based DAA therapy prior to transplantation and who then received SOF/VEL/VOX after transplant.CONCLUSION This case series demonstrate the real-world efficacy and safety of SOF/VEL/VOX in the post liver transplant setting.Treatment was successful with all patients achieving SVR,it was well tolerated,and there were minimal drug-drug interactions with their immunosuppressants.展开更多
目的:系统评价索磷维伏在真实世界中作为丙型肝炎病毒(HCV)挽救治疗的有效性和安全性。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、ClinicalTrials.gov、中国知网、万方、维普和中国生物医学文献等数据库,纳入...目的:系统评价索磷维伏在真实世界中作为丙型肝炎病毒(HCV)挽救治疗的有效性和安全性。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、ClinicalTrials.gov、中国知网、万方、维普和中国生物医学文献等数据库,纳入以索磷维伏为挽救治疗方案的真实世界研究。根据ROBINS-I工具对纳入研究的质量进行评价。采用Stata 15.0和RevMan 5.4软件进行Meta分析。结果:共纳入11项研究,包括1460例HCV感染者,持续治疗12周的人群总体持续病毒应答(SVR12)率为93%(95%CI:0.91~0.95),基因3型人群的SVR12率明显低于非基因3型(OR=0.35,95%CI:0.15~0.81,P=0.01),肝硬化人群的SVR12率低于非肝硬化人群(OR=0.46,95%CI:0.22~0.92,P=0.03)。不良事件(AE)发生率为39.47%。最常见的AE为头痛(11.05%)、乏力(7.37%)、恶心(6.14%)、疲劳(5.96%)和腹泻(5.26%)。因AE而终止治疗的仅有5人。结论:与临床试验结果一致,索磷维伏适用于既往治疗失败的HCV患者,是一种高效且耐受性良好的挽救性治疗方案。展开更多
文摘BACKGROUND Direct-acting antiviral(DAA)therapy regimens are highly effective at eliminating hepatitis C virus(HCV)infection but rates of sustained virologic response(SVR)are lower in patients with decompensated cirrhosis or hepatocellular carcinoma.Since many of these patients will be referred for liver transplant,they will require retreatment after transplantation.Sofosbuvir/velpatasvir/voxilaprevir(SOF/VEL/VOX)is recommended by guidelines as the preferred regimen to treat HCV in DAA-experienced patients following liver transplant however there is limited data.CASE SUMMARY We present the cases of six liver transplant recipients who had previous treatment failure with sofosbuvir-based DAA therapy prior to transplantation and who then received SOF/VEL/VOX after transplant.CONCLUSION This case series demonstrate the real-world efficacy and safety of SOF/VEL/VOX in the post liver transplant setting.Treatment was successful with all patients achieving SVR,it was well tolerated,and there were minimal drug-drug interactions with their immunosuppressants.
