title: Sofosbuvir plus simeprevir treatment of recurrent genotype 1 hepatitis C after liver transplant.
abstract: BACKGROUND
  Patients with recurrent hepatitis C (HCV) infection post-liver transplant can be difficult to treat safely and effectively. A prior (COSMOS) study in patients with non-transplant HCV, using sofosbuvir plus simeprevir, had high efficacy and tolerability in treating patients with HCV genotype 1, even prior non-responders to interferon therapy and those with cirrhosis. Our aim was to evaluate the efficacy of sofosbuvir and simeprevir in patients with genotype 1 HCV post-liver transplant.
  
  
  METHODS
  In this prospective, observational study, patients received sofosbuvir 400 mg plus simeprevir 150 mg daily for 12 wk without ribavirin. The primary end point was a sustained virologic response 12 wk after the end of therapy.
  
  
  RESULTS
  Forty-two patients completed the treatment. Twenty-six percent started the treatment ≤ 6 months post-liver transplant. Nineteen percent of the included patients had cirrhosis, 14% with decompensation. At week 4 on the treatment, 21% of patients had detectable virus but at the end of the treatment, 100% were undetectable. Twelve weeks after the end of the treatment, 95% of the patients had undetectable hepatitis C. The regimen was generally well tolerated.
  
  
  CONCLUSIONS
  The oral regimen of sofosbuvir plus simeprevir without ribavirin is efficacious and well tolerated in the treatment of patients with genotype 1 hepatitis C post-liver transplant.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Carmi Santos
authors.initials: CS
authors.lastname: Punzalan
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Curtis
authors.initials: C
authors.lastname: Barry
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Isabel
authors.initials: I
authors.lastname: Zacharias
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Rodrigues
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Savant
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Adel
authors.initials: A
authors.lastname: Bozorgzadeh
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Graham F
authors.initials: GF
authors.lastname: Barnard
mesh_terms: D064591:Allografts; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000472:pathogenicity; D006526:Hepatitis C / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D000069616:Simeprevir / Q000627:therapeutic use*; D000069474:Sofosbuvir / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: direct acting antiviral agents; hepatitis C; liver transplant; simeprevir; sofosbuvir