Crushing and Splitting Direct-Acting Antivirals for Hepatitis C Virus Treatment: A Case Series and Literature Review

Whelchel, Kristen; Zuckerman, Autumn D; Koren, David E.; Derrick, Caroline; Bouchard, Jeannette; Chastain, Cody A.

doi:10.1093/ofid/ofab525

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Additionally, successful treatment of chronic HCV infection with crushed GLE/PIB via percutaneous gastrostomy tube has been reported in three adults. 5 Our two cases document real-world success with early nasoenteric administration of crushed and dissolved GLE/PIB for ddHCV in two young adult cardiac transplant recipients, one of whom completed his entire 12-week course via NGT and achieved SVR12. These cases provide evidence for nasoenteric GLE/PIB administration that enables earlier DAA initiation following transplantation with organs from HCV-viremic donors.…”

Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 83%

Successful nasoenteric administration of glecaprevir/pibrentasvir for donor‐derived hepatitis C in two young adult heart transplant recipients at a pediatric transplant center

Kushner

Puckett

Lee

et al. 2022

Pediatric Transplantation

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Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 83%

Successful nasoenteric administration of glecaprevir/pibrentasvir for donor‐derived hepatitis C in two young adult heart transplant recipients at a pediatric transplant center

Kushner

Puckett

Lee

et al. 2022

Pediatric Transplantation

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“…These outcomes led some institutions to delay initiation of GLE/PIB until patients could reliably tolerate oral medications and swallow the tablets whole. A recently published case series showed 100% SVR in ten patients treated with various DAA regimens, including GLE/PIB tablets that were split or crushed for oral or percutaneous endoscopic gastrostomy (PEG) tube administration 43 . Similarly, their review of the available literature identified an additional 11 cases which reported 100% SVR with tablet manipulation of various DAA regimens.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of direct acting antiviral therapies in hepatitis C virus‐negative liver transplant recipients of hepatitis C‐viremic donors

et al. 2022

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The introduction of safe and highly effective direct acting antivirals (DAAs) has significantly improved hepatitis C virus (HCV) treatment outcomes after transplant. The solid organ transplant community has sought to identify strategies aimed at increasing the donor pool including the utilization of HCV‐viremic organs in HCV‐negative recipients. We will review the existing literature to evaluate DAA use for the treatment of HCV viremia post‐liver transplant in patients who receive HCV‐viremic allografts. A PubMed search was conducted and references for each study were also reviewed to identify additional articles. Randomized controlled trials, cohort studies, case series, and case reports were included if: published in English language, evaluated DAA treatment outcomes after liver only or simultaneous liver‐kidney transplantation with HCV‐viremic allografts in HCV‐negative recipients, and had full‐text article availability. Our review included 16 studies and 2 case reports. The majority of liver transplant recipients were treated with a pangenotypic DAA for 12 weeks with a heterogeneous median time to initiation (range 1.7–118 days). Sustained virologic response was assessed in 253 liver transplant patients with 99.6% achieving cure with minimal DAA‐attributed adverse drug events. There were 23 reported episodes of rejection, 12 deaths, and 1 graft loss among all studies. Treatment with DAA after transplantation of HCV‐viremic livers into HCV‐negative recipients appears to be safe and effective; however, long‐term outcomes remain unknown. Transplant pharmacists play a key role in the development of center‐specific protocols to optimize post‐transplant outcomes in this unique patient population.

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“…The availability of the age‐appropriate formulations is still a major global concern. Recent evidence suggests that tablet manipulation (halving and crushing) does not impact the safety and effectiveness of HCV DAA 46 …”

Section: Monitoring Of Treatment With Daa In Children With Chronic He...mentioning

confidence: 99%

“…Recent evidence suggests that tablet manipulation (halving and crushing) does not impact the safety and effectiveness of HCV DAA. 46…”

Section: Monitoring Of Treatment With Daa In Children With Chronic He...mentioning

confidence: 99%

ESPGHAN recommendations on treatment of chronic hepatitis C virus infection in adolescents and children including those living in resource‐limited settings

Indolfi,

Gonzalez‐Peralta,

Jonas

et al. 2024

J. pediatr. gastroenterol. nutr.

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Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, with more than three million viraemic adolescents and children. Treatment of adults with HCV infection and HCV‐related liver disease has advanced considerably thanks to development and improvements in therapy. Direct‐acting antiviral regimens are safe and effective. Three regimens with pangenotypic activity (glecaprevir/pibrentasvir, sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir) and three regimens with genotype‐specific activity (sofosbuvir/ribavirin, sofosbuvir/ledipasvir and elbasvir/grazoprevir) have been approved with age‐specific limitation for treatment of children with chronic hepatitis C by the European Medicines Agency and the United States Food and Drug Administration. The World Health Organization has set the ambitious target to eliminate hepatitis C as a major public health threat by 2030 and based its actions against HCV on the large use of direct acting antivirals. These updated European Society for Pediatric Gastroenterology, Hepatology and Nutrition recommendations on treatment of hepatitis C describe the optimal therapeutic management of adolescents and children with HCV infection including specific indications for those living in resource‐limited settings.

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Crushing and Splitting Direct-Acting Antivirals for Hepatitis C Virus Treatment: A Case Series and Literature Review

Cited by 6 publications

References 23 publications

Successful nasoenteric administration of glecaprevir/pibrentasvir for donor‐derived hepatitis C in two young adult heart transplant recipients at a pediatric transplant center

Successful nasoenteric administration of glecaprevir/pibrentasvir for donor‐derived hepatitis C in two young adult heart transplant recipients at a pediatric transplant center

A systematic review of direct acting antiviral therapies in hepatitis C virus‐negative liver transplant recipients of hepatitis C‐viremic donors

ESPGHAN recommendations on treatment of chronic hepatitis C virus infection in adolescents and children including those living in resource‐limited settings

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