Spontaneous Clearance of Hepatitis C after Liver and Renal Transplantation

Dale, C.S.; Burns, Patsy; McCutcheon, Mark A.; Hernandez‐Alejandro, Roberto; Marotta, P.

doi:10.1155/2009/912848

Cited by 19 publications

(6 citation statements)

References 9 publications

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“…It was also reported after liver transplantation for HCVehuman immunodeficiency virus (HIV) coinfected patient [11] as well as in patients with combined liver and kidney transplantation [12]. We report a case of spontaneous clearance of HCV genotype 4 after cadaveric liver retransplantation.…”

mentioning

confidence: 75%

Spontaneous Clearance of Hepatitis C Genotype 4 After Liver Retransplantation

Elsiesy

Abaalkhail

Sebayel

et al. 2015

Transplantation Proceedings

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mentioning

confidence: 75%

Spontaneous Clearance of Hepatitis C Genotype 4 After Liver Retransplantation

Elsiesy

Abaalkhail

Sebayel

et al. 2015

Transplantation Proceedings

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“…Recognizing a lack of immediate post-transplant HCV testing in our series, we cannot definitely exclude early viremia with HCV clearance as a theoretical biological explanation for HCV seropositivity. However, donor derived HCV is typically associated with early and persistent viremia and accelerated HCV-related hepatic disease in the recipient [16]. Cases of spontaneous viral clearance and seroconversion have been reported, but are exceptional, occurring many years after transplant and in association with a reduction in immunosuppression [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Transmitted Donor Immunology Not Infection: Common Persistence of Donor Hepatitis C Antibody Production in Aviremic Lung Transplant Recipients

Smibert¹,

Doyle²,

Jenney³

et al. 2021

OBM Transplantation

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Since 2018 The American Society of Transplant has recommended that Hepatitis C Virus seropositive positive, non-viremic donors (HCVAb+/NAT-) be considered non-infectious and safe for transplantation. This report describes clinical outcomes and HCV serological and virological outcomes following lung transplantation (LTx) utilizing such donors. This retrospective cohort study describes seven HCVAb+/NAT- donors used for bilateral LTx. Donor information was sourced from the national organ donation service and recipient information from the institutional LTx database. Seven deceased donors (three female, median age 53, range 37-63 years) acquired HCV from injecting drug use (n=4), blood products (n=1), unknown (n=1). Four donors had been previously treated and cleared of HCV (sustained virological response at 24 weeks) before death. Seven recipients (2 female, median age 56, range 51-71 years), with pulmonary fibrosis (n=4), re-do LTx (n=3), were waitlisted a median of 87 days (range 8-362). At post-LTx follow up, six of seven are alive with excellent graft function at a median 1625 days (range 779-2582). No patient developed clinical, biochemical or virological evidence of HCV infection, however five recipients demonstrated persistent HCVAb+ (all consistently NAT-) for a median 414 days (range 332-872) post-LTx. Two patients HCVAb sero-reverted at d731 and d1461. Two other recipients remained HCVAb- at d1621 and d1398 on repeat testing. There was no evidence of HCV transmission to seven LTx recipients from HCVAb+/NAT- life-saving lung donors, however persistent HCV Ab positivity was seen in 5 LTx recipients with two demonstrating remote sero-reversion. We postulate this may be a form of Passenger Lymphocyte Syndrome.

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“…Such an outcome has substantial implications when evaluating, for example, treatment strategies against HCV before and after liver transplantation in patients with advanced liver fibrosis [ 40 ]. It has been reported that spontaneous clearance of HCV after transplantation is rare while reinfection of the allograft is common; therefore reducing the prognosis of these patients [ 41 – 44 ]. Adopting antiviral drugs that could eradicate the virus from the bloodstream and reduce the risk of reinfection of the allograft could then potentially generate substantial savings in MRU-related costs and improve the condition of the patient.…”

Section: Discussionmentioning

confidence: 99%

Determinant Factors of the Direct Medical Costs Associated with Genotype 1 Hepatitis C Infection in Treatment-Experienced Patients

Akpo¹,

Sbarigia

Wan

et al. 2015

Drugs R D

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ObjectiveLimited evidence is available on predictors of medical resource utilization (MRU) and related direct costs, especially in treatment-experienced patients infected with genotype 1 hepatitis C virus (HCV). This study aimed at investigating patient and treatment characteristics that predict MRU and related non-drug costs in treatment-experienced patients with chronic hepatitis C (CHC) treated with simeprevir (SMV) or telapravir (TVR) in combination with pegylated interferon and ribavirin (PegIFN/R).Patients and MethodsA total of 709 patients who completed the 72-week ATTAIN trial were included in the study. Cost data were analysed from the UK NHS perspective. Descriptive statistics and regression analyses were used to determine patterns and predictors of total MRU-related costs associated with SMV/PegIFN/R and TVR/PegIFN/R.ResultsIndependent predictors for total MRU-related costs were age, region and the following interaction terms: (1) gender × F3–F4 METAVIR score × baseline viral load (BLVL), (2) body mass index (BMI) × F3–F4 METAVIR score × prior response to PegIFN/R and (3) gender × achievement of SVR at 12 weeks (SVR12) × BLVL. A F3–F4 METAVIR score was a stronger predictor of total MRU-related costs than SVR12. Predictors of adverse events included older age, female gender, low BMI, TVR/PegIFN/R and SVR12. Wilcoxon rank sum test revealed comparable total MRU-related costs between SMV/PegIFN/R and TVR/PegIFN/R.ConclusionTo the best of our knowledge, this study is the first to describe the relationship between commonly admitted predictors of MRU-related costs and their joint effect on total MRU-related costs in treatment-experienced patients with CHC. The identified predictors of MRU-related costs suggest that significant treatment costs can be avoided by starting treatment early before the disease progresses. Furthermore, adverse events seem to be the most important factor to take into consideration for the choice of treatment, especially when therapeutic options are associated with similar levels of medical resource utilization and associated costs.Electronic supplementary materialThe online version of this article (doi:10.1007/s40268-015-0109-5) contains supplementary material, which is available to authorized users.

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Spontaneous Clearance of Hepatitis C after Liver and Renal Transplantation

Cited by 19 publications

References 9 publications

Spontaneous Clearance of Hepatitis C Genotype 4 After Liver Retransplantation

Spontaneous Clearance of Hepatitis C Genotype 4 After Liver Retransplantation

Transmitted Donor Immunology Not Infection: Common Persistence of Donor Hepatitis C Antibody Production in Aviremic Lung Transplant Recipients

Determinant Factors of the Direct Medical Costs Associated with Genotype 1 Hepatitis C Infection in Treatment-Experienced Patients

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