HIV+ 肾移植受者应用来迪派韦索磷布韦成功治疗丙型肝炎。
Successful Posttransplant Treatment of Hepatitis C With Ledipasvir-Sofosbuvir in HIV+ Kidney Transplant Recipients.
机构信息
1 Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA. 2 Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel University, Philadelphia, PA. 3 Division of Nephrology and Hypertension, Department of Medicine, Drexel University, Philadelphia, PA. 4 Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
出版信息
Transplantation. 2017 May;101(5):974-979. doi: 10.1097/TP.0000000000001336.
BACKGROUND
Ledipasvir-sofosbuvir is effective at eradicating hepatitis C virus (HCV) infection in the general population and in HCV-monoinfected kidney transplant recipients, but there are no data to guide its use in human immunodeficiency virus/HCV coinfected kidney transplant patients.
METHODS
We treated 6 human immunodeficiency virus/HCV coinfected kidney transplant recipients with ledipasvir-sofosbuvir at our 2 centers. All were infected with genotype 1 and 66% had received kidneys from HCV+ donors.
RESULTS
All patients cleared the virus while on therapy and 100% have achieved a sustained virologic response at 12 weeks after completion of ledipasvir-sofosbuvir. Tacrolimus dosing required adjustment during and after ledipasvir-sofosbuvir therapy but antiretroviral regimens did not.
CONCLUSIONS
Ledipasvir-sofosbuvir was well tolerated. Although all patients in our series were treated posttransplant, the ideal timing of HCV therapy in this population is unknown, and the impact of HCV clearance on posttransplant outcomes is yet to be determined.
背景
在普通人群和 HCV 单感染肾移植受者中，利迪帕韦-索磷布韦可有效清除丙型肝炎病毒 (HCV) 感染，但尚无数据指导其在 HIV/HCV 合并感染肾移植患者中的应用。
方法
我们在两个中心用利迪帕韦-索磷布韦治疗了 6 例 HIV/HCV 合并感染肾移植受者。所有患者均感染基因型 1，66%的患者接受了 HCV+供体的肾脏。
结果
所有患者在治疗期间均清除了病毒，并且在利迪帕韦-索磷布韦治疗结束后 12 周时，100%的患者获得了持续病毒学应答。在利迪帕韦-索磷布韦治疗期间和之后需要调整他克莫司的剂量，但不需要调整抗逆转录病毒方案。
结论
利迪帕韦-索磷布韦耐受良好。尽管我们系列中的所有患者均在移植后接受治疗，但该人群中 HCV 治疗的理想时机尚不清楚，HCV 清除对移植后结局的影响仍有待确定。
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