title: Treatment of recurrent genotype 1 hepatitis C post-liver transplantation: single center experience with telaprevir-based triple therapy.
abstract: Recurrent HCV infection post-liver transplantation (post-LT) is still a major challenge in the treatment of hepatitis C virus (HCV) infection. In this retrospective analysis we gathered data about treatment response and safety of all 14 post-LT patients who were treated between 2011 and 2013 at our centre with a telaprevir (TVR)-based triple therapy. Seven out of 14 patients completed the full treatment course of 48 weeks. Five patients achieved a SVR 24, while 3 additional HCV RNA-negative patients are still in follow-up (end of treatment, SVR 12 and 22). Four patients discontinued treatment prematurely due to side effects. A virological non-response at TW 4 was seen in 1 patient. Virological breakthrough was observed in 2 patients at TW 16 and 28, respectively; 1 patient displayed a virological relapse after the end of treatment (EOT). Patients with a complicated course post-LT accumulated most of the severe side effects, largely infections. One patient with cholestatic hepatitis died 11 weeks after discontinuation of treatment due to progressive graft failure. In conclusion, TVR-based triple therapy in post-LT patients reveals an acceptable antiviral efficacy. Unfortunately, severe side effects are frequent and often require therapeutic interventions. Therefore, with the approval of less straining DAA like sofosbuvir in sight, TVR-based triple therapy in post-LT patients should be, if possible avoided.
authors.affiliation: University Hospital Tübingen, Medical Clinic, Department of Gastroenterology, Hepatology, and Infectiology, Tübingen, Germany.
authors.forename: C R
authors.initials: CR
authors.lastname: Werner
authors.affiliation: University Hospital Tübingen, Medical Clinic, Department of Gastroenterology, Hepatology, and Infectiology, Tübingen, Germany.
authors.forename: D P
authors.initials: DP
authors.lastname: Egetemeyr
authors.affiliation: University Hospital Tübingen, Department of General, Visceral and Transplant Surgery, Tübingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Nadalin
authors.affiliation: University Hospital Tübingen, Department of General, Visceral and Transplant Surgery, Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Königsrainer
authors.affiliation: University Hospital Tübingen, Medical Clinic, Department of Gastroenterology, Hepatology, and Infectiology, Tübingen, Germany.
authors.forename: N P
authors.initials: NP
authors.lastname: Malek
authors.affiliation: University Hospital Tübingen, Medical Clinic, Department of Gastroenterology, Hepatology, and Infectiology, Tübingen, Germany.
authors.forename: U M
authors.initials: UM
authors.lastname: Lauer
authors.affiliation: University Hospital Tübingen, Medical Clinic, Department of Gastroenterology, Hepatology, and Infectiology, Tübingen, Germany.
authors.forename: C P
authors.initials: CP
authors.lastname: Berg
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage*; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; C486464:telaprevir