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Safety and effectiveness of direct acting antivirals for treatment of hepatitis C virus in patients with solid organ transplantation
Author(s) -
Mansour Marlina,
Hill Lucas,
Kerr Janice
Publication year - 2018
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.12972
Subject(s) - medicine , immunosuppression , simeprevir , hepatitis c virus , hepatitis c , sofosbuvir , liver transplantation , daclatasvir , population , transplantation , gastroenterology , immunology , virus , ribavirin , environmental health
Background The direct acting antivirals ( DAA s) for treatment of hepatitis C virus ( HCV ) infection have sustained virologic response ( SVR ) rates of greater than 90% in most patients. However, data evaluating DAA use in transplant patients are limited. The goal of this study was to evaluate the effectiveness and safety of HCV treatment in this high‐risk population. Methodology This single‐center retrospective study included liver, kidney, lung, and/or heart transplant patients who were treated for HCV infection with DAA s. The primary objective was to identify drug‐drug interactions between DAA s and immunosuppressants by comparing immunosuppression dosages and levels at baseline and week 4 of HCV treatment. As secondary objectives, we described the percentage of patients with new or worsening rejection and/or graft dysfunction during HCV treatment, and the percentage of study patients who achieved SVR . Results Of the 108 patients included, the majority had liver (76%) or kidney (13%) transplants. Simeprevir plus sofosbuvir was the most commonly prescribed HCV treatment (33.9%) and tacrolimus was the most common immunosuppressant (91%). We did not detect a statistically significant difference in immunosuppression dosages or levels during HCV treatment. Furthermore, only one patient (<1%) experienced rejection and five patients (4.6%) had six episodes of graft dysfunction while on DAA s. Efficacy was high with 98% of patients achieving SVR . Conclusion DAAs appear to be safe and effective for HCV treatment in patients with a history of liver and/or kidney transplantation. More data are needed to evaluate DAA s in lung and/or heart transplant patients.