Τίτλος:
Efficacy and safety of new direct-acting antivirals in kidney transplant recipients with chronic hepatitis c: A single-center study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background The recent interferon-free direct-acting antiviral (DAA) regimens have very good safety and efficacy profiles and are highly recommended for kidney transplant (KT) recipients with chronic hepatitis C (CHC). Methods All KT recipients with CHC followed at our hospital and who received therapy with the current DAAs were included. At the baseline visit, demographic, clinical and laboratory variables before and after KT, as well as at the commencement of DAAs, at the end of antiviral therapy and the end of follow up, were recorded, including assessment of glomerular filtration rate (eGFR). The changes in eGFR (DGFR) between baseline and end of therapy (1st period), and between end of therapy and end of follow up (2nd period), were evaluated. Results Twelve KT recipients were retrospectively evaluated: 2 had received antiviral therapy in the past; 4 (33.3%) patients had genotype 1 and 3 (25%) genotype 4 CHC. The median stiffness was 11.9 kPa (range 5-16.8), while 5 patients, none with decompensated cirrhosis, had stiffness >12.5 kPa. Eight patients received a sofosbuvir-containing antiviral regimen (Group 1) and 4 patients received an antiviral regimen without sofosbuvir (Group 2). Eleven (91.7%) patients achieved a sustained virological response (SVR). One patient discontinued DAAs early after treatment and did not achieve SVR. Otherwise, DAAs were well tolerated and no rejection episode was recorded. The DGFRs in the 1st period and 2nd period did not differ significantly between Group 1 and Group 2 patients. Conclusion In this real-world study of KT recipients with CHC, the high efficacy and clinically acceptable tolerability of DAAs were confirmed. © 2020 Hellenic Society of Gastroenterology.
Συγγραφείς:
Darema, M.
Cholongitas, E.
Filiopoulos, V.
Marinaki, S.
Pavlopoulou, I.D.
Tsoubou, I.
Boletis, J.N.
Papatheodoridis, G.V.
Περιοδικό:
Annals of Gastroenterological Surgery
Εκδότης:
Hellenic Society of Gastroenterology
Λέξεις-κλειδιά:
alanine aminotransferase; aspartate aminotransferase; creatinine; daclatasvir; dasabuvir plus ombitasvir plus paritaprevir plus ritonavir; elbasvir plus grazoprevir; ledipasvir plus sofosbuvir; peginterferon; ribavirin; sofosbuvir; sofosbuvir plus velpatasvir, adult; anemia; antiviral therapy; Article; chronic hepatitis C; clinical article; cohort analysis; controlled study; diarrhea; DRESS syndrome; drug efficacy; drug safety; drug withdrawal; enzyme immunoassay; fatigue; female; follow up; graft recipient; headache; human; kidney graft; leukopenia; liver stiffness; male; middle aged; real time polymerase chain reaction; retrospective study; shear wave elastography; sustained virologic response; treatment response
DOI:
10.20524/aog.2020.0481
