Efficacy and safety of sofosbuvir‐based therapy in hepatitis C virus recurrence post living donor liver transplant: A real life egyptian experience. Issue 4 (14th December 2018)

• Record Type: Journal Article
• Authors: Yosry, Ayman; Gamal Eldeen, Hadeel; Medhat, Eman; Mehrez, Mai; Zayed, Naglaa; Elakel, Wafaa; Abdelmoniem, Reham; Kaddah, Mona; Abdelaziz, Ashraf; Esmat, Gamal; EL‐Serafy, Magdy; Doss, Wahid
• Is Part Of: Journal of medical virology. Volume 91:Issue 4(2019)
• Page Start: 668
• Page End: 676
• Publication Date: 2018-12-14
• Subjects: DAAs -- efficacy and safety -- HCV -- LDLT; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25362
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract : Background and Aim: Direct acting antiviral has offered treatment of hepatitis C virus (HCV) recurrence post liver transplantation (LT) with an all‐oral regimen for short duration, excellent safety profile, and high sustained virological response (SVR). The aim of this study was to evaluate the efficacy and safety of sofosbuvir (SOF)‐based regimens in the real world among a cohort of Egyptian patients with recurrent HCV post living donor LT (LDLT). Methods: Patients with HCV‐G4 recurrence post‐LDLT were recruited from National Committee of Control of Viral Hepatitis, Egypt, from November 2014 to May 2017. They received different SOF‐based regimens according to the treatment protocols available during this period. Patients' outcome and Adverse effects (AE) were evaluated. Results: One hundred ninety patients (170 males, mean age 56.8 ± 7.9 years) were included. Calcineurin inhibitors were the main immunosuppression used (173 patients). Out of 190, 119 (62.6%) received SOF/ribavirin (RBV), 38 (20%) SOF/simeprevir (SMV), 22 (11.6%) SOF/daclatasvir (DSV)/ ± RBV, and 11 (5.8%) received SOF/LDV/ ± RBV. Overall SVR12 was 89.5%, 84.9% in SOF/RBV group, 94.7% in SOF/SMV, 100% in SOF/DCV, and 100% in SOF/LDV with no statistically significant difference ( P = 0.104). The AE reported were as follows: anemia (n = 65, 34.4%) mainly in SOF/RBV group, transient hyperbilirubinemia during SOF/SMV in 13 patients (34%), mild Acute cellular rejection in eight patients (4.2%), and hepatocellular carcinoma in two patients (1%) mainly driven by underlying liver condition. Two deaths were unlikely related to HCV therapy. Conclusion: Different SOF‐based regimens were effective with high SVR12 rates in a difficult‐to‐treat population, recurrent HCV post LDLT.