Bridging all oral DAA therapy from wait time to post-liver transplant to improve HCV eradication?

被引:26
作者
Donato, Maria Francesca [1 ]
Monico, Sara [1 ]
Malinverno, Federica [1 ]
Aghemo, Alessio [1 ]
Maggioni, Marco [2 ]
Reggiani, Paolo [3 ]
Colombo, Massimo [1 ]
机构
[1] Univ Milan, Gastroenterol & Hepatol Unit, Fdn IRCCS Ca Granda Osped Maggiore Policlin, I-20122 Milan, Italy
[2] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Pathol Unit, Milan, Italy
[3] Univ Milan, Liver Transplant Ctr, Fdn IRCCS Ca Granda Osped Maggiore Policlin, I-20122 Milan, Italy
关键词
antiviral therapy; hepatitis C; recurrent disease; retransplantation; RECURRENT HEPATITIS-C; ANTIVIRAL THERAPY; PREVENT RECURRENCE; SOFOSBUVIR; INFECTION; RIBAVIRIN; EFFICACY; VIRUS; REINFECTION; SURVIVAL;
D O I
10.1111/liv.12646
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Recurrence of hepatitis C is a major cause of graft loss and shortened survival in patients receiving a liver transplant (LT) for end-stage hepatitis C virus (HCV) infection. The only way to improve graft and patient outcomes is a successful eradication of HCV infection by antiviral therapy either before or after transplant. This was achievable in a small proportion of recipients by IFN-based regimens, but could be obtained in the majority of them by using DAA IFN-free regimens before/after transplant. Methods: We describe a patient with decompensated cirrhosis because of severe recurrent hepatitis C, who had a retransplant following treatment with a combination of sofosbuvir and riba virin that started during the waiting time and was carried over during both the transplant and post-transplant phases for an overall period of 24 weeks. The patient gave a written consent to receive Sofosbuvir plus Rbv therapy pre and post-transplant. Results: Post-transplant serum HCV-RNA remains undetectable 24 weeks after discontinuing sofosbuvir and ribavirin (SVR24). Conclusions: Waiting for direct antiviral agents combinations, our findings not only support the use of sofosbuvir plus ribavirin as the first-line treatment in all patients on the LT waiting list, but also suggest to bridge treatment to the post-transplant period in case HCV RNA undetectability for at least 30 days has not been achieved at the time of LT.
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页码:1 / 4
页数:4
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