Monday, July 11, 2016

Sofosbuvir-based treatment of hepatitis C with severe fibrosis (METAVIR F3/F4) after liver transplantation: Results from the CO23 ANRS CUPILT study.


Recurrence of HCV after liver transplantation (LT) can rapidly lead to liver graft cirrhosis, and therefore graft failure and re-transplantation or death. The aim of the present study was to assess efficacy and tolerance of sofosbuvir (SOF)-based regimens for the treatment of HCV recurrence in patients with severe fibrosis after LT. The CUPILT study is a prospective multicenter cohort including patients with HCV-recurrence following LT treated with second generation direct antivirals. The present study focused on patients included between Oct 2013 and Nov 2014 and diagnosed with HCV recurrence and liver graft extensive fibrosis (METAVIR F3/F4). A SOF-based regimen was administered to 125 patients fulfilling inclusion criteria. The median delay from LT was 95.9 ± 69.6 months. The characteristics of patients were: mean age: 59.4 ± 9.0 years; male: 78.4%, infected by HCV G1: 78.2%, mean HCV RNA: 6.1 ± 1.0 log IU/ml. Eighty patients had failed previous post-LT antiviral therapy (64.0%) including triple therapy with first generation protease inhibitors in 19 (15.2%) cases. The main combination regimen was SOF/daclatasvir (73.6%). Ribavirin was used in 60 patients. Sustained virological response 12 weeks after treatment was 92.8% (on an intent-to-treat basis); seven cases of virological failure were observed. Serious adverse-events occurred in 25.6% of the patients during antiviral treatment. During antiviral treatment and follow-up, 3 patients were re-transplanted and 4 patients died. In conclusion, SOF-based antiviral treatment shows very promising results in patients with HCV recurrence and severe fibrosis after LT. This article is protected by copyright. All rights reserved.
© 2016 American Association for the Study of Liver Diseases.

No comments:

Post a Comment