Kawagishi Naoki, Nakamura Atsushi, Takayama Tetsuro, Haga Izumi
Division of Transplant Surgery, JCHO Sendai Hospital, Sendai, Japan.
Ther Apher Dial. 2020 Apr;24(2):184-188. doi: 10.1111/1744-9987.13350. Epub 2019 Aug 16.
Treatment of chronic hepatitis C infection after renal transplantation has been controversial due to the high rate of graft rejections with interferon (IFN)-based therapies. The aim of this study is to review our experience of direct acting antiviral therapy for the recipients of renal transplantation. Eleven recipients who were hepatitis C virus-polymerase chain reaction (PCR) positive were eligible for the treatment with direct acting antivirals. Six recipients were treated with sofosbuvir and ledipasvir, three were treated with elbasvir and grazoprevir, and one was treated with sofosbuvir and ribavirin for 12 weeks. One recipient was treated with glecaprevir and pibrentasvir for 8 weeks. All of the 11 recipients exhibited sustained virologic response at week 12 after the end of treatment. Adverse events were scarce including the two recipients who switched to tacrolimus from cyclosporine at the beginning of the treatment. The direct acting antiviral therapy including new agents appears to be safe and highly efficacious for the recipients after renal transplantation.
由于基于干扰素（IFN）的疗法会导致较高的移植排斥率，肾移植后慢性丙型肝炎感染的治疗一直存在争议。本研究的目的是回顾我们对肾移植受者进行直接抗病毒治疗的经验。11名丙型肝炎病毒聚合酶链反应（PCR）呈阳性的受者符合接受直接抗病毒药物治疗的条件。6名受者接受了索磷布韦和来迪帕司韦治疗，3名受者接受了艾尔巴韦和格拉瑞韦治疗，1名受者接受了索磷布韦和利巴韦林治疗12周。1名受者接受了格卡瑞韦和哌仑他韦治疗8周。所有11名受者在治疗结束后第12周均表现出持续病毒学应答。不良事件很少，包括2名在治疗开始时从环孢素转换为他克莫司的受者。包括新型药物在内的直接抗病毒治疗对肾移植后的受者似乎是安全且高效的。
