Omichi Kiyohiko, Akamatsu Nobuhisa, Mori Kazuhiro, Togashi Junichi, Arita Junichi, Kaneko Junichi, Hasegawa Kiyoshi, Sakamoto Yoshihiro, Kokudo Norihiro
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hepatol Res. 2017 Oct;47(11):1093-1101. doi: 10.1111/hepr.12845. Epub 2016 Dec 15.
This study aimed to clarify the efficacy and safety of interferon-free therapy using asunaprevir and daclatasvir, or sofosbuvir and ledipasvir for post living donor liver transplantation (LDLT) recipients with hepatitis C virus (HCV).
A retrospective cohort study of LDLT recipients with HCV genotype 1b treated with asunaprevir (100 mg twice daily) and daclatasvir (60 mg once daily), or sofosbuvir (400 mg/day) and ledipasvir (90 mg/day) was carried out.
Ten patients without mutations in the area of L31 and Y93 completed the treatment with asunaprevir and daclatasvir. Five of them had end-stage chronic kidney disease, including three hemodialysis patients. Of the 10 patients, nine completed the protocol of 24 weeks; one stopped the treatment due to the development of aortic valve stenosis. All nine patients who completed the 24-week treatment protocol achieved end of treatment response. Nineteen patients received treatment with sofosbuvir and ledipasvir. Of the 19 patients, 18 completed the protocol of 12 weeks; one stopped treatment due to severe interstitial pneumonia. All 18 patients who completed the 12-week treatment protocol achieved end of treatment response. All patients in both treatment groups who completed the regimen and reached 3 months after the end of treatment achieved sustained virological response at 12 weeks after treatment. Liver functions were significantly improved at the end of treatment, and no adverse events were observed.
Interferon-free therapy using asunaprevir and daclatasvir, or sofosbuvir and ledipasvir, is highly effective for post-LDLT recipients with HCV genotype 1b.
本研究旨在阐明使用阿舒瑞韦和达卡他韦，或索磷布韦和来迪派韦进行无干扰素治疗对丙型肝炎病毒（HCV）感染的活体肝移植（LDLT）受者的疗效和安全性。
对接受阿舒瑞韦（每日两次，每次100毫克）和达卡他韦（每日一次，每次60毫克），或索磷布韦（每日400毫克）和来迪派韦（每日90毫克）治疗的HCV基因1b型LDLT受者进行回顾性队列研究。
10例L31和Y93区域无突变的患者完成了阿舒瑞韦和达卡他韦治疗。其中5例患有终末期慢性肾脏病，包括3例血液透析患者。10例患者中，9例完成了24周治疗方案；1例因主动脉瓣狭窄进展而停止治疗。所有完成24周治疗方案的9例患者均实现了治疗结束时的应答。19例患者接受了索磷布韦和来迪派韦治疗。19例患者中，18例完成了12周治疗方案；1例因严重间质性肺炎停止治疗。所有完成12周治疗方案的18例患者均实现了治疗结束时的应答。两个治疗组中所有完成治疗方案且在治疗结束后3个月达到12周治疗的患者均实现了持续病毒学应答。治疗结束时肝功能显著改善，未观察到不良事件。
使用阿舒瑞韦和达卡他韦，或索磷布韦和来迪派韦进行无干扰素治疗对HCV基因1b型LDLT受者非常有效。
