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 18 February 2018

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News

Treatment of HCV infection in liver transplant recipients

The latest issue of the Alimentary Pharmacology & Therapeutics investigates the treatment of HCV infection in liver transplant recipients with ledipasvir and sofosbuvir without ribavirin.

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Ledipasvir and sofosbuvir is a well-tolerated regimen with high sustained virological response rates in pre-liver transplant patients infected with chronic hepatitis C virus (HCV), but data in liver transplant recipients outside of clinical trials is limited.

Dr Joel Wedd and colleagues from Georgia, USA addressed this knowledge gap and assessed sustained virological response rates without the use of ribavirin in liver transplant recipients.

The researchers performed a retrospective study examining the treatment of 75 post-liver transplant recipients with ledipasvir and sofosbuvir without ribavirin. 

A total of 408 genotype 1, HCV patients were treated with ledipasvir/sofosbuvir from 2014 to 2015.

The research team reported that 73 patients were post-liver transplant, and were treated with a median of 3 years from transplant. 

Only 3% had recurrent allograft cirrhosis
Alimentary Pharmacology & Therapeutics
Ledipasvir/sofosbuvir achieved an sustained virological response rate at week 12 of 96%. 

African Americans made up 29% of the cohort. 

The team reported that 63% of patients were treated previously, including 14% of patients previously treated with direct-acting antivirals. 

The research team found that only 3% had recurrent allograft cirrhosis, and the majority was on calcineurin inhibitor based immunosuppressive therapy. 

Approximately 82% of patients had chronic kidney disease stage 2 or 3. 

The team observed that only detectable week 8 viral load was predictive of failure to achieve sustained virological response.

Dr Wedd's team comments, "Our data confirm excellent sustained virological response outcomes and favorable safety and tolerability profiles with ledipasvir/sofosbuvir without ribavirin in post-liver transplant recipients infected with HCV, despite treatment guidelines to use ribavirin."

Aliment Pharmacol Ther 2017: 45(11): 1427–1432
12 May 2017

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