Saab Sammy, Rheem Justin, Jimenez Melissa A, Fong Tiffany M, Mai Michelle H, Kachadoorian Caterina A, Esmailzadeh Negin L, Bau Sherona N, Kang Susan, Ramirez Samantha D, Grotts Jonathan, Choi Gina, Durazo Francisco A, El-Kabany Mohammed M, Han Steven-Huy B, Busuttil Ronald W
Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
Departments of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
J Clin Transl Hepatol. 2017 Jun 28;5(2):101-108. doi: 10.14218/JCTH.2016.00070. Epub 2017 May 14.
Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality. We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C. Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks. The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months. The mean (± SD) age of the cohort was 63 (±8.6) years old. Most recipients were male (70%). Baseline alanine transaminase, total bilirubin, and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126) mg/dL, 0.8 (±1.3) U/L, and 8,010,421.9 (±12,420,985) IU/mL, respectively. Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects, with 4 of those being anemia complications. No recipient discontinued the ledipasvir/sofosbuvir. Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy, and all recipients had complete viral suppression at the end of therapy. The sustained viral response at 12 weeks after completion of therapy was 94%. : Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT. Anemia is not uncommon in LT recipients receiving ribavirin.
肝移植（LT）受者中丙型肝炎病毒（HCV）的反复感染很常见，且与显著的发病率和死亡率相关。我们回顾性评估了来迪派韦/索磷布韦联合或不联合利巴韦林治疗基因型1丙型肝炎复发的LT受者的安全性和疗效。85例LT受者接受了来迪派韦/索磷布韦联合或不联合利巴韦林治疗12周或24周，以治疗HCV复发。从LT到开始治疗的平均（±标准差[SD]）时间为68（±71）个月。该队列的平均（±SD）年龄为63（±8.6）岁。大多数受者为男性（70%）。基线丙氨酸转氨酶、总胆红素和HCV核糖核酸（RNA）值（±SD）分别为76.8（±126）mg/dL、0.8（±1.3）U/L和8,010,421.9（±12,420,985）IU/mL。43例接受利巴韦林治疗的受者中有5例因副作用而停药，其中4例为贫血并发症。没有受者停用过来迪派韦/索磷布韦。81%的受者在开始治疗4周后病毒水平检测不到，所有受者在治疗结束时病毒均得到完全抑制。治疗完成后12周的持续病毒学应答率为94%。：来迪派韦和索磷布韦联合或不联合利巴韦林治疗是LT后复发性HCV感染的一种有效且耐受性良好的无干扰素治疗方法。接受利巴韦林治疗的LT受者中贫血并不少见。
