直接作用抗病毒药物时代下，免疫抑制治疗停药后丙型肝炎病毒肝移植患者的抗病毒治疗结局：病例系列研究。
Outcomes of antiviral treatment in hepatitis C virus liver transplant patients off immunosuppression in the direct acting antivirals era: A case series.
机构信息
Universidade de Santiago de Compostela (CLINURSID), Santiago de Compostela, Spain.
Department of Internal Medicine, Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
出版信息
Clin Transplant. 2018 Jul;32(7):e13303. doi: 10.1111/ctr.13303. Epub 2018 Jun 25.
BACKGROUND
Clearance of hepatitis C virus (HCV) under antiviral therapy, including direct-acting antivirals (DAAs), has been associated with higher risk of rejection. Whether patients who are not on immunosuppression (IS) during DAA therapy are at higher risk of rejection is unknown.
METHODS
Four transplant recipients who were off IS and treated with DAA therapy were identified.
RESULTS
All patients were genotype 1 infection and treated for 12 weeks with sofosbuvir/ledipasvir/ribavirin. At the time of DAA therapy, patients were off IS for a median of 9.5 years. Time from liver transplant (LT) to treatment was 12.9 years. Median baseline ALT was 70 IU/L, at follow-up week 12 was 18 IU/L. No signs of rejection were observed during DAA therapy or follow-up after the end of therapy. All 4 patients obtained sustained virological response.
CONCLUSION
Direct-acting antivirals therapy in HCV patients off IS post-LT can be successfully undertaken without the need to restart IS.
背景
抗病毒治疗（包括直接作用抗病毒药物）清除丙型肝炎病毒（HCV）与更高的排斥风险相关。在接受直接作用抗病毒药物治疗期间未接受免疫抑制治疗（IS）的患者是否具有更高的排斥风险尚不清楚。
方法
确定了 4 名正在接受 DAA 治疗且未接受 IS 的移植受者。
结果
所有患者均为基因型 1 感染，接受索磷布韦/维帕他韦/利巴韦林治疗 12 周。在 DAA 治疗时，患者停止 IS 治疗的中位时间为 9.5 年。从肝移植（LT）到治疗的时间为 12.9 年。基线 ALT 的中位数为 70 IU/L，治疗后 12 周为 18 IU/L。在 DAA 治疗期间或治疗结束后的随访期间均未观察到排斥迹象。所有 4 例患者均获得持续病毒学应答。
结论
HCV 患者在 LT 后停止 IS 接受直接作用抗病毒药物治疗，可以在无需重新开始 IS 的情况下成功进行。
Zotero 插件