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. 2017 Jun 28;5(2):101-108.
doi: 10.14218/JCTH.2016.00070. Epub 2017 May 14.

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C

Sammy Saab  1   2 , Justin Rheem  3 , Melissa A Jimenez  2 , Tiffany M Fong  2 , Michelle H Mai  2 , Caterina A Kachadoorian  2 , Negin L Esmailzadeh  2 , Sherona N Bau  1   2 , Susan Kang  1   2 , Samantha D Ramirez  2 , Jonathan Grotts  4 , Gina Choi  1   2 , Francisco A Durazo  1   2 , Mohammed M El-Kabany  1   2 , Steven-Huy B Han  1   2 , Ronald W Busuttil  1   2
Affiliations

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C

Sammy Saab et al. J Clin Transl Hepatol. .

Abstract

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.

Keywords: Direct-acting agents; Hepatitis C; Immunosuppressant; Liver transplantation; Sustained viral response.

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Conflict of interest statement

The authors have no conflict of interests related to this publication.

Figures

Fig. 1.
Fig. 1.. Patient disposition.
Abbreviations: LDV, ledipasvir; SOF, sofosbuvir; RBV, ribavirin; SVR, sustained viral response.
Fig. 2.
Fig. 2.. Overall viral kinetics.
Abbreviation: SVR, sustained viral response.
Fig. 3.
Fig. 3.. Fibrosis-4 score at baseline and SVR12.
Abbreviations: FIB-4, fibrosis-4 score; SVR, sustained viral response.
See this image and copyright information in PMC

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