Premium
Course of hepatitis C virus ( HCV ) RNA and HCV core antigen testing are predictors for reaching sustained virologic response in liver transplant recipients undergoing sofosbuvir treatment in a real‐life setting
Author(s) -
Pischke S.,
Polywka S.,
Proske V.M.,
Lang M.,
Jordan S.,
Nashan B.,
Lohse A.W.,
Sterneck M.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12475
Subject(s) - medicine , sofosbuvir , hepatitis c virus , regimen , hepatitis c , daclatasvir , gastroenterology , liver transplantation , hepacivirus , negativity effect , antigen , immunology , virus , transplantation , ribavirin , psychology , social psychology
Background Hepatitis C virus ( HCV ) infection is associated with reduced graft survival in orthotopic liver transplant recipients. Treatment with the new direct‐acting antivirals ( DAA s) is safe and efficient, but no reliable predictive factors for sustained virologic response ( SVR ) have been identified so far. The HCV core antigen assay ( HCV ‐core‐Ag) is a new, inexpensive, and efficient method to detect viral antigens, but the value of this technique to predict treatment response in orthotopic liver transplantation ( OLT ) patients is still unclear. Methods All OLT patients who were treated with a sofosbuvir‐based antiviral regimen at our center between March 2014 and August 2014 were included in the analysis ( n = 20). HCV ‐core‐Ag and HCV RNA (polymerase chain reaction [ PCR ]) were determined at each visit. Primary endpoints of this study were SVR at 4 or 12 weeks after end of treatment ( SVR 4 and SVR 12). Results HCV ‐core‐Ag tested negative after a median of 2 weeks (range 1–16 weeks) while PCR tests became negative after a median of 4 weeks (range 2–12 weeks). Time until PCR negativity and until HCV ‐core‐Ag negativity showed a good correlation ( R = 0.711, P < 0.001, Fig. [Figure 1. Correlation (Pearson) of treatment duration until negativity of PCR ...]). Seventeen of 20 patients (85%) achieved SVR 12. SVR 12 was associated with a short time interval between treatment start and HCV PCR negativity ( P = 0.005) or HCV ‐core‐Ag negativity ( P = 0.003, Mann–Whitney test). No severe side effects were observed. Conclusions DAA treatment is safe and well tolerated in OLT . The time points of HCV ‐core‐Ag loss and PCR negativity were predictors of SVR 12.