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Outcomes of treatment with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation
Author(s) -
Honda Masaki,
Sugawara Yasuhiko,
Watanabe Takehisa,
Tateyama Masakuni,
Tanaka Motohiko,
Uchida Koushi,
Kawabata Seiichi,
Yoshii Daiki,
Miura Kouhei,
Isono Kaori,
Hayashida Shintaro,
Ohya Yuki,
Yamamoto Hidekazu,
Sasaki Yutaka,
Inomata Yukihiro
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12853
Subject(s) - daclatasvir , medicine , ribavirin , simeprevir , gastroenterology , regimen , hepatitis c , adverse effect , pegylated interferon , hepatitis c virus , transplantation , sofosbuvir , virology , virus
Aim The development of direct‐acting oral agents has dramatically changed the treatment strategy of hepatitis C virus (HCV) infection. Here we aimed to reveal the efficacy and safety of daclatasvir (DCV) and asunaprevir (ASV) for recurrent HCV genotype 1 infection after liver transplantation (LT). Methods A retrospective study was undertaken on nine patients who underwent a 24‐week DCV/ASV treatment regimen for recurrent HCV genotype 1 infection. Five of the patients were men; four had failed treatment with pegylated interferon (Peg‐IFN)/ribavirin, two had failed simeprevir/Peg‐IFN/ribavirin, one had the resistance‐associated variant Y93H in the NS5A region, and one underwent maintenance dialysis. Results Median time to treatment initiation following LT was 70 months. Of the nine patients treated with DCV/ASV, eight (88.9%) achieved a sustained viral response 12 weeks after completion of therapy (SVR12). The patient with virologic failure had failed simeprevir/Peg‐interferon/ribavirin therapy 4 months before undergoing the DCV/ASV treatment regimen. In addition, a resistance‐associated variant D168E in the NS3 region was detected in the patient after discontinuation of the DCV/ASV regimen. The trough level of tacrolimus tended to decrease, and renal function showed no significant changes during treatment. Adverse events occurred in two patients (22.2%), but no severe adverse events occurred during treatment. Conclusions The DCV/ASV regimen was well tolerated, resulting in high rates of sustained viral response 12 weeks after completion of therapy for LT patients with recurrent HCV genotype 1 infection.