Successful treatment of chronic hepatitis C infection with directly acting antivirals in renal transplant recipients

2017 Nephrology (Carlton) In Press;

AIMS: The data regarding the treatment of chronic hepatitis C (CHC) in renal transplant recipients is lacking from the Asia-Pacific region. Aim of the present study was to assess the safety and efficacy of directly acting antivirals (DAAs) in the treatment of CHC infection in renal transplant recipients. METHODS: A total of 47 CHC infected renal transplant recipients were enrolled in this real life observational cohort analysis between March 2015 and September 2016. Presence of hepatic fibrosis/cirrhosis was assessed on transient elastography (Fibroscan). Fourteen patients were treated with Sofosbuvir and Ribavirin for 24 weeks. Twenty-two patients received Sofosbuvir and Ledipasvir and twelve patients received Sofosbuvir and Daclatasvir with (n = 3) or without (n = 31) Ribavirin for 12 or 24 weeks depending on genotype and underlying cirrhosis. Data was analyzed for safety and treatment efficacy [sustained virological response at 12 weeks (SVR12)]. RESULTS: The median baseline HCV RNA concentration in the whole group was 7.38 x 10(6) IU/ml (1.23 x 10(4) - 6.36 X 10(7) ). The SVR12 rates were 100% in all groups except in the Sofosbuvir and Ribavirin group (86%). Transient Elastography revealed minimal or no fibrosis (F0-F1) in 31 (65.96%) patients, moderate fibrosis (F2) in 11 (23.4%) patients and cirrhosis in 5 (10.64%) patients. The only serious adverse effect was anemia observed in 8 (57%) patients in the Sofosbuvir and Ribavirin group. CONCLUSION: DAAs including Sofosbuvir, Daclatasvir and Ledipasvir with or without ribavirin are safe and effective for the treatment of chronic hepatitis C in renal transplant recipients.

Pubmed : 28703905