Direct‐acting antiviral agent–based regimen for HCV recurrence after combined liver‐kidney transplantation: Results from the ANRS CO23 CUPILT study. Issue 11 (19th October 2017)

• Record Type: Journal Article
• Authors: Dharancy, Sébastien; Coilly, Audrey; Fougerou‐Leurent, Claire; Duvoux, Christophe; Kamar, Nassim; Leroy, Vincent; Tran, Albert; Houssel‐Debry, Pauline; Canva, Valérie; Moreno, Christophe; Conti, Filoména; Dumortier, Jérome; Di Martino, Vincent; Radenne, Sylvie; De Ledinghen, Victor; D'Alteroche, Louis; Silvain, Christine; Besch, Camille; Perré, Philippe; Botta‐Fridlund, Danielle; Francoz, Claire; Habersetzer, François; Montialoux, Hélène; Abergel, Armand; Debette‐Gratien, Maryline; Rohel, Alexandra; Rossignol, Emilie; Samuel, Didier; Duclos‐Vallée, Jean‐Charles; Pageaux, Georges‐Philippe
• Is Part Of: American journal of transplantation. Volume 17:Issue 11(2017)
• Page Start: 2869
• Page End: 2878
• Publication Date: 2017-10-19
• Subjects: clinical research/practice -- infection and infectious agents – viral: hepatitis C -- infectious disease -- kidney failure/injury -- kidney transplantation/nephrology -- liver disease: infectious -- liver transplantation/hepatology; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14490
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Hepatitis C virus (HCV) infection is associated with reduced patient survival following combined liver‐kidney transplantation (LKT). The aim of this study was to assess the efficacy and safety of second‐generation direct‐acting antivirals (DAAs) in this difficult‐to‐treat population. The ANRS CO23 "Compassionate use of Protease Inhibitors in Viral C Liver Transplantation" (CUPILT) study is a prospective cohort including transplant recipients with recurrent HCV infection treated with DAAs. The present work focused on recipients with recurrent infection following LKT. The study population included 23 patients. All patients received at least one NS5B inhibitor (sofosbuvir) in their antiviral regimen an average of 90 months after LKT. Ninety‐six percent of recipients achieved a sustained virological response (SVR) at week 12 (SVR12). In terms of tolerance, 39% of recipients presented with at least one serious adverse event. None of the patients experienced acute rejection during therapy and there were no deaths during follow‐up. The glomerular filtration rate (GFR) decreased significantly from baseline to the end of therapy. However, this study did not show that the decline in GFR persisted over time or that it was directly related to DAAs. The DAA‐based regimen is well tolerated with excellent results in terms of efficacy. It will become the gold standard for the treatment of recurrent HCV following LKT. Abstract : In liver–kidney recipients with recurrent hepatitis C chronic infection, treatment with second‐generation direct active antivirals for 12 or 24 weeks is safe and well tolerated, and results in a sustained virological response rate of 95.7% in patients.