Sofosbuvir and simeprevir is effective for recurrent hepatitis C in liver transplant recipients.
OBJECTIVE
Hepatitis C is the most common indication for liver transplantation (LT). Recurrent infection is universal and can lead to progressive liver disease. Widespread use of interferon-based therapy has been limited by intolerability and adverse effects.


METHODS
We retrospectively evaluated the safety, tolerability, and efficacy of sofosbuvir and simeprevir in the treatment of recurrent hepatitis C in adult (age >18) LT recipients.


RESULTS
Seventy-six percent of the recipients were male and the mean age [±standard deviation (SD)] was 61 (±6.0) years. The mean time (±SD) from LT to treatment initiation was 71.8 (±77.1) months. Of the 26 patients with viral levels measured 4 weeks after starting antiviral therapy, 58% were undetectable. At the end of therapy, viral load was undetectable in all transplant recipients. The 12 week sustained viral response (SVR) was 93%. All recipients were able to complete therapy and no patients required growth factors of blood product transfusion during treatment. No patient required drug interruption of their immunosuppressant therapy.


CONCLUSIONS
The use of sofosbuvir and simeprevir is efficacious, safe, and tolerable and should be considered in LT recipients with recurrent HCV who are candidates for antiviral therapy.
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.|Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Sammy
S
Saab
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Adam
A
Greenberg
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Edwin
E
Li
Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Sherona Ngashea
SN
Bau
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.|Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Francisco
F
Durazo
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.|Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Mohammed
M
El-Kabany
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.|Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Steven
S
Han
Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Ronald W
RW
Busuttil
D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D000069616:Simeprevir / Q000009:adverse effects / Q000627:therapeutic use*; D000069474:Sofosbuvir / Q000009:adverse effects / Q000627:therapeutic use*; D066027:Transplant Recipients; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D012367:RNA, Viral; D000069616:Simeprevir; D000069474:Sofosbuvir
antiviral therapy; hepatitis C; liver transplant recipients