title: Ledipasvir/sofosbuvir without ribavirin is effective in the treatment of recurrent hepatitis C virus infection post-liver transplant.
abstract: OBJECTIVE
  Recurrent hepatitis C virus infection is a challenging complication post-liver transplant. Current guidelines recommend the combination of ribavirin and ledipasvir/sofosbuvir for 12 weeks for the treatment of recurrent HCV genotype 1 post-liver transplant. Data are limited on the use of ledipasvir/sofosbuvir without ribavirin. The aim of this study was to evaluate the use of ledipasvir/sofosbuvir without ribavirin for the treatment of recurrent hepatitis C virus post-liver transplant.
  
  
  METHODS
  This is a retrospective study of liver transplant patients who received ledipasvir/sofosbuvir without ribavirin for the treatment of recurrent hepatitis C virus in our liver center from 2014 to 2016.
  
  
  RESULTS
  A total of 60 patients were enrolled of which 70% were male, 88% Caucasian, age 60 ± 7 years, 15% cirrhotic, and 45% treatment-experienced with recurrent hepatitis C virus infection genotype 1 post-liver transplant. Treatment duration varied from 8 to 24 weeks. There were no serious adverse events and no discontinuation of treatment. A total of 71% of patients had undetectable serum hepatitis C virus at 4 weeks. However, irrespective of treatment duration, 100% of patients had undetectable serum hepatitis C virus at the end of treatment and 100% of patients achieved sustained viral response at 12 weeks.
  
  
  CONCLUSIONS
  Ledipasvir/sofosbuvir without ribavirin is an effective treatment of recurrent hepatitis C virus infection post-liver transplant. The entire group achieved sustained viral response at 12 weeks irrespective of the length of treatment. The combination of ledipasvir/sofosbuvir was well tolerated without serious adverse effects or discontinuation.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 1808 7th Ave South, BDB 391, Birmingham, AL, 5294, USA.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shoreibah
authors.affiliation: Department of Internal Medicine, Tinsley Harrison Internal Medicine Residency Program, University of Alabama at Birmingham, 1720 2nd Ave South, BDB 327, Birmingham, AL, 35294, USA. jordanorr@uabmc.edu.
authors.forename: Jordan
authors.initials: J
authors.lastname: Orr
authors.affiliation: The University of Alabama at Birmingham, 1802 6th Ave South, Birmingham, 35233, AL, USA.
authors.forename: DeAnn
authors.initials: D
authors.lastname: Jones
authors.affiliation: The University of Alabama at Birmingham, 1802 6th Ave South, Birmingham, 35233, AL, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Montgomery Internal Medicine Residency Program, University of Alabama at Birmingham, 2055 E. South Blvd., Suite 200, Montgomery, 36116, AL, USA.
authors.forename: Krishna
authors.initials: K
authors.lastname: Venkata
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 1808 7th Ave South, BDB 391, Birmingham, AL, 5294, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Massoud
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005449:Fluorenes / Q000008:administration & dosage / Q000627:therapeutic use*; D019698:Hepatitis C, Chronic / Q000517:prevention & control*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D000069474:Sofosbuvir; D016896:Treatment Outcome; D014542:Uridine Monophosphate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D001562:Benzimidazoles; D005449:Fluorenes; C000595958:ledipasvir, sofosbuvir drug combination; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: HCV; Ledipasvir/sofosbuvir; Liver transplant