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The impact of directly acting antivirals on the enzymatic liver function of liver transplant recipients with recurrent hepatitis C
Author(s) -
Raschzok Nathanael,
Schott Eckart,
ReutzelSelke Anja,
Damrah Iman,
GülKlein Safak,
Strücker Benjamin,
Sauer Igor Maximilian,
Pratschke Johann,
Eurich Dennis,
Stockmann Martin
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.12606
Subject(s) - medicine , daclatasvir , sofosbuvir , ribavirin , gastroenterology , liver function , cirrhosis , simeprevir , cholestasis , hepatitis c , tacrolimus , liver function tests , hepatitis c virus , liver transplantation , immunology , transplantation , virus
Background The new directly acting antivirals ( DAA s) enable all‐oral interferon‐free treatment of chronic hepatitis C virus ( HCV ) infection. We here investigated the effect of DAA s on the enzymatic liver function of liver transplant recipients with recurrent hepatitis C. Methods Twenty‐one patients with elevated liver enzymes or advanced fibrosis/compensated cirrhosis caused by recurrent HCV were treated with sofosbuvir either in combination with simeprevir, or in combination with ribavirin or daclatasvir with or without ribavirin for 12 weeks. Biochemical parameters, tacrolimus trough levels, and the maximal liver function capacity (Li MA x) were measured monthly during the treatment and 12 weeks after the end of treatment. Results All patients achieved sustained virological response 12 weeks after the end of the treatment. The transaminases and cholestasis parameters normalized until week 8 of treatment. The mean Li MA x (normal ranges >315 μg/kg/h) increased from 344±142 μg/kg/h before treatment to 458±170 μg/kg/h ( P <.0001) at the 12‐week follow‐up. In parallel, the tacrolimus trough level to dose ratio decreased from 4.68 down to 2.72 ( P =.0004). Conclusion Antiviral treatment with DAA s enabled sustained elimination of recurrent HCV in liver transplant recipients and was associated with a significant improvement of the enzymatic liver function.