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Utilization and efficacy of elbasvir/grazoprevir for treating hepatitis C virus infection after liver transplantation
Author(s) -
Miuma Satoshi,
Miyaaki Hisamitsu,
Soyama Akihiko,
Hidaka Masaaki,
Takatsuki Mitsuhisa,
Shibata Hidetaka,
Taura Naota,
Eguchi Susumu,
Nakao Kazuhiko
Publication year - 2018
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.13204
Subject(s) - daclatasvir , medicine , ledipasvir , combination therapy , gastroenterology , sofosbuvir , ribavirin , hepatitis c virus , immunology , virus
Aim Recently, elbasvir/grazoprevir combination therapy (EBR/GZR) was reported to have excellent antiviral effects for chronic genotype 1 hepatitis C virus (HCV) infection. However, it has not been recommended for patients with post‐liver transplant (LT) HCV re‐infections because of a lack of evidence for effectiveness and drug–drug interactions. Methods We report the usage of EBR/GZR in five post‐LT HCV re‐infected patients with the kinetics of renal function and tacrolimus trough levels during and after therapy. Furthermore, to evaluate the antiviral effects, we examined the HCV kinetics during and after therapy and compared this with other interferon‐free therapy in post‐LT patients ( n = 19). Results All patients treated with EBR/GZR therapy obtained rapid virologic response and sustained at 12 weeks post‐treatment. There was no evidence of worsening estimated glomerular filtration rates. Three patients were given tacrolimus as immunosuppressive therapy and its trough levels were controllable with dosage adjustments. One patient developed grade 1 diarrhea 3 days after therapy induction. To evaluate the antiviral effects of EBR/GZR therapy for these patients, we compared them to the effects of daclatasvir/asunaprevir combination therapy ( n = 8) and sofosbuvir/ledipasvir combination therapy ( n = 11). The EBR/GZR combination was not inferior to other therapies in its early phase and late‐phase antiviral effects. Conclusions Although further studies with a larger number of patients are required, we suggest that EBR/GZR therapy is an alternative therapy for patients with post‐LT genotype 1 HCV re‐infection.