Ledipasvir/sofosbuvir is effective and well tolerated in postkidney transplant patients with chronic hepatitis C virus.

MedStar author(s):
Citation: Clinical Transplantation. 31(5), 2017 MayPMID: 28239909Institution: MedStar Washington Hospital CenterDepartment: Transplant HepatologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Benzimidazoles/tu [Therapeutic Use] | *Coinfection/dt [Drug Therapy] | *Fluorenes/tu [Therapeutic Use] | *Hepacivirus/de [Drug Effects] | *Hepatitis C, Chronic/dt [Drug Therapy] | *Kidney Failure, Chronic/su [Surgery] | *Kidney Transplantation/ae [Adverse Effects] | *Postoperative Complications/dt [Drug Therapy] | *Uridine Monophosphate/aa [Analogs & Derivatives] | Antiviral Agents | Female | Follow-Up Studies | Glomerular Filtration Rate | Graft Survival | Hepacivirus/ge [Genetics] | Hepatitis C, Chronic/vi [Virology] | Humans | Immunosuppressive Agents/tu [Therapeutic Use] | Kidney Function Tests | Male | Middle Aged | Postoperative Complications/vi [Virology] | Prognosis | Retrospective Studies | Risk Factors | Uridine Monophosphate/tu [Therapeutic Use]Year: 2017ISSN:
  • 0902-0063
Name of journal: Clinical transplantationAbstract: Copyright (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.Patients with end-stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients, treatment for HCV is delayed until postrenal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 postkidney transplant patients infected with HCV. The group was composed predominantly of treatment-naive (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78.1%). A 96% sustained viral response (SVR) was reported (27/28 patients). One patient relapsed. One patient with baseline graft dysfunction developed borderline rejection. No graft loss was reported. Six HIV-coinfected patients were included in our analysis. Five of these patients achieved SVR 12. There were four deaths, and one of the deaths was in the HIV group. None of the deaths were attributed to therapy. Coinfected patients tolerated therapy well with no serious adverse events. Serum creatinine remained stable at baseline, end of therapy, and last follow-up, (1.351+/-.50 mg/dL; 1.406+/-.63 mg/dL; 1.290+/-.39 mg/dL, respectively). In postkidney transplant patients with HCV infection with or without coinfection with HIV, a combination of LDV/SOF was well tolerated and effective.All authors: Hassan M, Lalos A, Liriano-Ward L, Morales AL, Nair V, Sang M, Satoskar R, Schiano T, Smith C, Tierney AFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Journal Article MedStar Authors Catalog Article 28239909 Available 28239909

Copyright (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Patients with end-stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients, treatment for HCV is delayed until postrenal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 postkidney transplant patients infected with HCV. The group was composed predominantly of treatment-naive (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78.1%). A 96% sustained viral response (SVR) was reported (27/28 patients). One patient relapsed. One patient with baseline graft dysfunction developed borderline rejection. No graft loss was reported. Six HIV-coinfected patients were included in our analysis. Five of these patients achieved SVR 12. There were four deaths, and one of the deaths was in the HIV group. None of the deaths were attributed to therapy. Coinfected patients tolerated therapy well with no serious adverse events. Serum creatinine remained stable at baseline, end of therapy, and last follow-up, (1.351+/-.50 mg/dL; 1.406+/-.63 mg/dL; 1.290+/-.39 mg/dL, respectively). In postkidney transplant patients with HCV infection with or without coinfection with HIV, a combination of LDV/SOF was well tolerated and effective.

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