title: Sofosbuvir and simeprevir combination therapy in the setting of liver transplantation and hemodialysis.
abstract: We report safety, tolerability, and 12-week sustained virologic response with half-standard dose sofosbuvir and standard-dose simeprevir combination therapy in a hepatitis C virus genotype 1a-infected liver transplant recipient on hemodialysis - uncharted territory for sofosbuvir-based therapy. The patient was a non-responder to prior treatment with pegylated interferon plus ribavirin. Sofosbuvir efficacy was maintained despite pill-splitting and administration of half-standard dose, 200 mg per day. No drug-drug interactions were noted with tacrolimus-based immunosuppression. Laboratory tests remained stable or improved during therapy. Our observation, if reproduced in a larger study, may lead to significant improvement in clinical outcomes and cost savings in this patient population.
authors: Division of Gastroenterology and Hepatology, Liver Transplant Program, Stanford University School of Medicine, Stanford, California, USA.
authors: R B
authors: RB
authors: Perumpail
authors: R J
authors: RJ
authors: Wong
authors: L D
authors: LD
authors: Ha
authors: E A
authors: EA
authors: Pham
authors: U
authors: U
authors: Wang
authors: H
authors: H
authors: Luong
authors: R
authors: R
authors: Kumari
authors: T J
authors: TJ
authors: Daugherty
authors: J P
authors: JP
authors: Higgins
authors: Z M
authors: ZM
authors: Younossi
authors: W R
authors: WR
authors: Kim
authors: J S
authors: JS
authors: Glenn
authors: A
authors: A
authors: Ahmed
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D000069616:Simeprevir / Q000627:therapeutic use*; D000069474:Sofosbuvir / Q000627:therapeutic use*; D066027:Transplant Recipients; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: direct-acting antivirals; hemodialysis; hepatitis C virus; liver transplantation; simeprevir; sofosbuvir