title: Ledipasvir/sofosbuvir is effective and well tolerated in postkidney transplant patients with chronic hepatitis C virus.
abstract: Patients with end-stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients, treatment for HCV is delayed until postrenal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 postkidney transplant patients infected with HCV. The group was composed predominantly of treatment-naïve (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78.1%). A 96% sustained viral response (SVR) was reported (27/28 patients). One patient relapsed. One patient with baseline graft dysfunction developed borderline rejection. No graft loss was reported. Six HIV-coinfected patients were included in our analysis. Five of these patients achieved SVR 12. There were four deaths, and one of the deaths was in the HIV group. None of the deaths were attributed to therapy. Coinfected patients tolerated therapy well with no serious adverse events. Serum creatinine remained stable at baseline, end of therapy, and last follow-up, (1.351±.50 mg/dL; 1.406±.63 mg/dL; 1.290±.39 mg/dL, respectively). In postkidney transplant patients with HCV infection with or without coinfection with HIV, a combination of LDV/SOF was well tolerated and effective.
authors.affiliation: Transplant Hepatology Service, Medstar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Amilcar L
authors.identifier: 0000-0002-9812-9771
authors.initials: AL
authors.lastname: Morales
authors.affiliation: Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Luz
authors.initials: L
authors.lastname: Liriano-Ward
authors.affiliation: Division of Gastroenterology Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Tierney
authors.affiliation: Transplant Hepatology Service, Medstar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Sang
authors.affiliation: Transplant Hepatology Service, Medstar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lalos
authors.affiliation: Division of Gastroenterology Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassan
authors.affiliation: Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Vinay
authors.identifier: 0000-0002-4427-165X
authors.initials: V
authors.lastname: Nair
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schiano
authors.affiliation: Transplant Hepatology Service, Medstar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Satoskar
authors.affiliation: Transplant Hepatology Service, Medstar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Coleman
authors.initials: C
authors.lastname: Smith
mesh_terms: D000998:Antiviral Agents; D001562:Benzimidazoles / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy*; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000069474:Sofosbuvir; D014542:Uridine Monophosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D001562:Benzimidazoles; D005449:Fluorenes; D007166:Immunosuppressive Agents; C000595958:ledipasvir, sofosbuvir drug combination; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: HIV; chronic hepatitis C; kidney transplant; ledipasvir/sofosbuvir