title: Three patients treated with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation: Case report.
abstract: We previously reported our data on telaprevir or simeprevir used in combination with pegylated interferon (PEG IFN) and ribavirin (RBV) for the treatment of recurrent hepatitis C virus (HCV) genotype 1 infection after liver transplantation (LT). Here, we report three patients who achieved viral responses with no effect on the blood concentrations of immunosuppressive agents following daclatasvir and asunaprevir treatment. The first patient was a 57-year-old man with HCV-related liver cirrhosis who failed to respond to PEG IFN/RBV after living donor LT. He had been treated with 1 mg/day of tacrolimus. The second was a 63-year-old man with HCV-related liver cirrhosis and hepatocellular carcinoma who failed to respond to PEG IFN/RBV after living donor LT. He had been treated with 1 mg/day of tacrolimus. The third was a 61-year-old man with HCV-related liver cirrhosis. He had been treated with mycophenolate mofetil (MMF). Serum HCV RNA became undetectable by TaqMan polymerase chain reaction test after 4 weeks of daclatasvir and asunaprevir treatment in all patients, and no remarkable fluctuations in blood concentration were observed either in tacrolimus or in MMF during 24 weeks of therapy. No adverse events were observed, and all patients received the full dose of daclatasvir and asunaprevir over 24 weeks. Serum HCV RNA remained negative at 12 weeks after the end of treatment in all patients. The daclatasvir and asunaprevir treatment showed a remarkable viral response with little effect on blood levels of immunosuppressive agents for recurrent HCV genotype 1 infection after LT.
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Morio
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.|Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Nelson Hayes
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.|Laboratory for Digestive Diseases, Center for Genomic Medicine, RIKEN, Hiroshima, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ochi
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Ishiyama
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ide
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.affiliation: Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.|Liver Research Project Center, Hiroshima University, Hiroshima, Japan.|Laboratory for Digestive Diseases, Center for Genomic Medicine, RIKEN, Hiroshima, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
keywords: direct-acting antivirals; drug-drug interaction; hepatitis C virus; immunosuppressive agents; liver transplantation