title: Antiviral treatment with sofosbuvir and simeprevir in a kidney transplant recipient with HCV-decompensated cirrhosis: viral eradication and removal from the liver transplant waiting list.
abstract: Hepatitis C positive kidney transplant (KT) recipients are a difficult-to-treat subpopulation. Interferon-based therapies are contraindicated (or at least not used) in KT patients, due to the risk of allograft rejection, its poor tolerability and the low rates of sustained virological response (SVR) achieved with these therapies. Nevertheless, the use of direct-acting antiviral drugs (DAAs) will certainly provide new opportunities for hepatitis C treatment in the KT setting. Here, we report the case of a KT recipient with decompensated cirrhosis who received antiviral therapy with sofosbuvir, simeprevir, and ribavirin during 24 weeks while awaiting liver transplantation. Hepatitis C was eradicated, and the patient was removed from the transplant list. Although there is no safety and efficacy data regarding the use of DAAs in the KT setting, this case suggests that KT recipients may benefit from the use of new antiviral drugs with high SVR rates and an excellent safety profile.
authors.affiliation: Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CiberEHD, Barcelona, Spain.
authors.forename: Martin
authors.initials: M
authors.lastname: Bonacci
authors.affiliation: Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CiberEHD, Barcelona, Spain.
authors.forename: Maria-Carlota
authors.initials: MC
authors.lastname: Londoño
authors.affiliation: Nephrology Department, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Esforzado
authors.affiliation: Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CiberEHD, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Forns
authors.affiliation: Pharmacy Department, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Jose-Miguel
authors.initials: JM
authors.lastname: Sotoca
authors.affiliation: Nephrology Department, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Campistol
mesh_terms: D000284:Administration, Oral; D064591:Allografts; D000998:Antiviral Agents / Q000008:administration & dosage*; D005260:Female; D005838:Genotype; D006084:Graft Rejection; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000737:chemistry; D007668:Kidney / Q000821:virology; D016030:Kidney Transplantation; D008103:Liver Cirrhosis / Q000150:complications* / Q000188:drug therapy; D016031:Liver Transplantation; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications* / Q000601:surgery; D000069616:Simeprevir / Q000008:administration & dosage*; D000069474:Sofosbuvir / Q000008:administration & dosage*; D066027:Transplant Recipients; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: cirrhosis; hepatitis C treatment; kidney transplant