Sustained virological response to antiviral therapy improves survival rate in patients with recurrent hepatitis <scp>C</scp> virus infection after liver transplantation

Kawaoka, Tomokazu; Takahashi, Shoichi; Kawakami, Yoshiiku; Tsuge, Masataka; Hiramatsu, Akira; Imamura, Michio; Hyogo, Hideyuki; Aikata, Hiroshi; Ishiyama, K.; Tashiro, Hirotaka; Ohdan, Hideki; Tanaka, Junko; Chayama, Kazuaki

doi:10.1111/hepr.12447

Cited by 15 publications

(16 citation statements)

References 40 publications

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“…Up to 40 % of patients with cirrhosis develop decompensated chronic liver disease within a year of diagnosis and their mortality can be over 50 % [19]. On the other hand, treatment of rHCV infection of the graft and viral clearance is associated with lower graft failure rates [35,36]. However, the advent of non-invasive tests such as transient elastography (Fibroscan) has reduced the number of liver biopsies for this indication.…”

Section: Monitoring Patients With Rhcv Infectionmentioning

confidence: 99%

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review

2016

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Recurrent HCV infection (rHCV) of the liver allograft following transplantation is universal and is associated with poor graft and patient survival in comparison with other indications. Treatment of rHCV infection in the previous era with pegylated interferon and ribavirin was associated with low sustained virological response (SVR) due to poor tolerability, adverse events and graft rejection. Recently, directly acting antiviral drugs (DAA) have been approved for the treatment of hepatitis C infection and a number of clinical trials have been conducted across various centers in the management of rHCV infection of the graft. In this review we discuss about recent studies that have emerged on the use of NS5b polymerase inhibitor, sofosbuvir in combination with second generation protease inhibitor, simeprevir, fixed dose ledipasvir or daclatasvir with or without ribavirin in the treatment of post transplant rHCV infection.

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Section: Monitoring Patients With Rhcv Infectionmentioning

confidence: 99%

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review

2016

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“…In HCV-infected patients, the achievement of sustained virological response (SVR) after treatment reduces the risk of progression to clinical decompensation or development of hepatocellular carcinoma in cirrhotic patients and can even result in histological improvement in those with less advanced fibrosis. Some studies have evaluated this benefit in post-OLT patients as well as the impact on survival, but studies of long-term outcomes are lacking (10,12–16,21–25). …”

Section: Introductionmentioning

confidence: 99%

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Zanaga

Vigani

Angerami

et al. 2017

Braz J Med Biol Res

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Recurrent hepatitis C after orthotopic liver transplantation (OLT) is universal and can lead to graft failure and, consequently, reduced survival. Hepatitis C treatment can be used to prevent these detrimental outcomes. The aim of this study was to describe rates of hepatitis C recurrence and sustained virological response (SVR) to interferon-based treatment after OLT and its relationship to survival and progression of liver disease through retrospective analysis of medical records of 127 patients who underwent OLT due to cirrhosis or hepatocellular carcinoma secondary to chronic hepatitis C between January 2002 and December 2013. Fifty-six patients were diagnosed with recurrent disease, 42 started interferon-based therapy and 37 completed treatment. Demographic, treatment- and outcome-related variables were compared between SVR and non-responders (non-SVR). There was an overall 54.1% SVR rate with interferon-based therapies. SVR was associated with longer follow-up after treatment (median 66.5 vs 37 months for non-SVR, P=0.03) and after OLT (median 105 vs 72 months, P=0.074), and lower rates of disease progression (15 vs 64.7%, P=0.0028) and death (5 vs 35.3%, P=0.033). Regardless of the result of therapy (SVR or non-SVR), there was a significant difference between treated and untreated patients regarding the occurrence of death (P<0.001) and months of survival (P<0.001). Even with suboptimal interferon-based therapies (compared to the new direct-acting antivirals) there is a 54.1% SVR rate to treatment. SVR is associated with improved survival and reduced risks of clinical decompensation, loss of the liver graft and death.

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“…Thus, the use of IFN-based regimens has restricted the application of LT [5]. However, achievement of sustained virological response (SVR) results in favorable clinical outcomes in LT recipients [6]. …”

Section: Introductionmentioning

confidence: 99%

Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

et al. 2018

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PurposeThe proportion of liver recipients with HCV is gradually increasing in Korea. Limited data are available regarding the efficacy of direct antiviral agents (DAAs) in liver transplant recipients in Asia. We aimed to assess the efficacy and safety of DAAs in HCV-infected liver recipients in Korea.MethodsForty HCV-infected patients from 2 centers received DAAs in the pretransplant or posttransplant period between May 2015 and November 2016.ResultsDAA was administered in the pretransplant period in 6 patients and the posttransplant period in 34 patients. Dalastavir and asunaprevir (n = 2) and sofosbuvir/ledipasvir and ribvarin (n = 4) were used in the pretransplant period. HCV RNA was not detected before liver transplantation in all patients. Sustained virological response (SVR) at 12 and 24 weeks after liver transplantation was 100%. In the posttransplant period, 33 of 34 patients received sofosfovir-based therapy. SVR at 12 weeks in those patients was 94%. Recurrent virologic relapse developed in 2 patients because of HCC recurrence or treatment failure. Adverse events included anemia (n = 2) and abdominal discomfort (n = 1).ConclusionDAAs are an effective and well-tolerated treatment for HCV-infected recipients in Korea.

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Sustained virological response to antiviral therapy improves survival rate in patients with recurrent hepatitis C virus infection after liver transplantation

Abstract: SVR following IFN therapy contributes to improvement of survival rate in patients with recurrent post-LT HCV infection.

Cited by 15 publications

References 40 publications

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review

Management of post liver transplantation recurrent hepatitis C infection with directly acting antiviral drugs: a review

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Use of direct antiviral agents in liver transplant recipients with hepatitis C virus in Korea: 2-center experience

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