title: Simeprevir/pegylated interferon/ribavirin triple therapy for recurrent hepatitis C after living donor liver transplantation.
abstract: OBJECTIVE
  Simeprevir (SMV) is a protease inhibitor which demonstrates good tolerability and high antiviral response in patients with hepatitis C. The clinical outcomes of triple therapy using simeprevir, pegylated interferon and ribavirin (SMV/PEG IFN/RBV) for recurrent hepatitis C after living donor liver transplantation (LDLT) have not been well reported. In this study, we assessed the outcomes of patients with recurrent hepatitis C (genotype 1) after LDLT who received triple therapy at our hospital.
  
  
  METHODS
  SMV/PEG IFN/RBV was administrated for 12 weeks (triple therapy), followed by another 12 weeks or extended period of PEG IFN/RBV (dual therapy). Virological response, interaction with calcineurin inhibitors and adverse events were retrospectively analyzed.
  
  
  RESULTS
  Ten patients with recurrent hepatitis C after LDLT completed 12 weeks of triple therapy. Nine patients achieved rapid or early virological response, and one patient was a non-responder. The nine responders received subsequent dual therapy, and the duration of dual therapy was extended (24 to 36 weeks) in five cases. Although one patient was in relapse 8 weeks after completing the standard duration (12 weeks) of dual therapy, eight patients achieved sustained virological response for 12 weeks (SVR12). The SVR12 rate was 80%. Trough levels of calcineurin inhibitor did not show marked changes after introduction of SMV in all cases. There were no major adverse events associated with SMV.
  
  
  CONCLUSIONS
  SMV treatment may be a safe and effective option for recurrent hepatitis C after LDLT.
authors: Department of Surgery.
authors: Masahiro
authors: M
authors: Shinoda
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. h-ebi@xj8.so-net.ne.jp.
authors: Hirotoshi
authors: H
authors: Ebinuma
authors: Department of Surgery.
authors: Osamu
authors: O
authors: Itano
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Yoshiyuki
authors: Y
authors: Yamagishi
authors: Department of Surgery.
authors: Hideaki
authors: H
authors: Obara
authors: Department of Surgery.
authors: Minoru
authors: M
authors: Kitago
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Nobuhiro
authors: N
authors: Nakamoto
authors: Department of Surgery.
authors: Taizo
authors: T
authors: Hibi
authors: Department of Surgery.
authors: Hiroshi
authors: H
authors: Yagi
authors: Department of Surgery.
authors: Yuta
authors: Y
authors: Abe
authors: Department of Surgery.
authors: Kentaro
authors: K
authors: Matsubara
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Po-Sung
authors: PS
authors: Chu
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Yuko
authors: Y
authors: Wakayama
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Nobuhito
authors: N
authors: Taniki
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Akihiro
authors: A
authors: Yamaguchi
authors: Department of Surgery.
authors: Ryusuke
authors: R
authors: Amemiya
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Rei
authors: R
authors: Miyake
authors: Department of Surgery.
authors: Takamasa
authors: T
authors: Mizota
authors: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Takanori
authors: T
authors: Kanai
authors: Department of Surgery.
authors: Yuko
authors: Y
authors: Kitagawa
keywords: calcineurin inhibitor; direct-acting antiviral agent; living donor liver transplantation; recurrent hepatitis C; simeprevir; virological response