title: Outcomes of treatment with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation.
abstract: OBJECTIVE
  The development of direct-acting oral agents has dramatically changed the treatment strategy of hepatitis C virus (HCV) infection. Here we aimed to reveal the efficacy and safety of daclatasvir (DCV) and asunaprevir (ASV) for recurrent HCV genotype 1 infection after liver transplantation (LT).
  
  
  METHODS
  A retrospective study was undertaken on nine patients who underwent a 24-week DCV/ASV treatment regimen for recurrent HCV genotype 1 infection. Five of the patients were men; four had failed treatment with pegylated interferon (Peg-IFN)/ribavirin, two had failed simeprevir/Peg-IFN/ribavirin, one had the resistance-associated variant Y93H in the NS5A region, and one underwent maintenance dialysis.
  
  
  RESULTS
  Median time to treatment initiation following LT was 70 months. Of the nine patients treated with DCV/ASV, eight (88.9%) achieved a sustained viral response 12 weeks after completion of therapy (SVR12). The patient with virologic failure had failed simeprevir/Peg-interferon/ribavirin therapy 4 months before undergoing the DCV/ASV treatment regimen. In addition, a resistance-associated variant D168E in the NS3 region was detected in the patient after discontinuation of the DCV/ASV regimen. The trough level of tacrolimus tended to decrease, and renal function showed no significant changes during treatment. Adverse events occurred in two patients (22.2%), but no severe adverse events occurred during treatment.
  
  
  CONCLUSIONS
  The DCV/ASV regimen was well tolerated, resulting in high rates of sustained viral response 12 weeks after completion of therapy for LT patients with recurrent HCV genotype 1 infection.
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Masaki
authors.initials: M
authors.lastname: Honda
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Gastroenterology and Hepatology, Postgraduate School of Life Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Gastroenterology and Hepatology, Postgraduate School of Life Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Masakuni
authors.initials: M
authors.lastname: Tateyama
authors.affiliation: Gastroenterology and Hepatology, Postgraduate School of Life Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Koushi
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kawabata
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Daiki
authors.initials: D
authors.lastname: Yoshii
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Miura
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Kaori
authors.initials: K
authors.lastname: Isono
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hayashida
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohya
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Gastroenterology and Hepatology, Postgraduate School of Life Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Departments of Transplantation/Pediatric Surgery.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Inomata
keywords: daclatasvir and asunaprevir; direct-acting antiviral drugs; hepatitis c; liver transplantation