BACKGROUND & AIMS: Recurrence of hepatitis C is a major cause of graft loss and shortened survival in patients receiving a liver transplant (LT) for end-stage hepatitis C virus (HCV) infection. The only way to improve graft and patient outcomes is a successful eradication of HCV infection by antiviral therapy either before or after transplant. This was achievable in a small proportion of recipients by IFN-based regimens, but could be obtained in the majority of them by using DAA IFN-free regimens before/after transplant. METHODS: We describe a patient with decompensated cirrhosis because of severe recurrent hepatitis C, who had a retransplant following treatment with a combination of sofosbuvir and riba virin that started during the waiting time and was carried over during both the transplant and post-transplant phases for an overall period of 24 weeks. The patient gave a written consent to receive Sofosbuvir plus Rbv therapy pre and post-transplant. RESULTS: Post-transplant serum HCV-RNA remains undetectable 24 weeks after discontinuing sofosbuvir and ribavirin (SVR24). CONCLUSIONS: Waiting for direct antiviral agents combinations, our findings not only support the use of sofosbuvir plus ribavirin as the first-line treatment in all patients on the LT waiting list, but also suggest to bridge treatment to the post-transplant period in case HCV RNA undetectability for at least 30 days has not been achieved at the time of LT.
BACKGROUND & AIMS: Recurrence of hepatitis C is a major cause of graft loss and shortened survival in patients receiving a liver transplant (LT) for end-stage hepatitis C virus (HCV) infection. The only way to improve graft and patient outcomes is a successful eradication of HCV infection by antiviral therapy either before or after transplant. This was achievable in a small proportion of recipients by IFN-based regimens, but could be obtained in the majority of them by using DAA IFN-free regimens before/after transplant. METHODS: We describe a patient with decompensated cirrhosis because of severe recurrent hepatitis C, who had a retransplant following treatment with a combination of sofosbuvir and riba virin that started during the waiting time and was carried over during both the transplant and post-transplant phases for an overall period of 24 weeks. The patient gave a written consent to receive Sofosbuvir plus Rbv therapy pre and post-transplant. RESULTS: Post-transplant serum HCV-RNA remains undetectable 24 weeks after discontinuing sofosbuvir and ribavirin (SVR24). CONCLUSIONS: Waiting for direct antiviral agents combinations, our findings not only support the use of sofosbuvir plus ribavirin as the first-line treatment in all patients on the LT waiting list, but also suggest to bridge treatment to the post-transplant period in case HCV RNA undetectability for at least 30 days has not been achieved at the time of LT.
Authors: Ashton A Shaffer; Alvin G Thomas; Mary Grace Bowring; Sarah E Van Pilsum Rasmussen; Ayla Cash; Lauren M Kucirka; Saleh A Alqahtani; Ahmet Gurakar; Mark S Sulkowski; Andrew M Cameron; Dorry L Segev; Christine M Durand Journal: Transpl Infect Dis Date: 2018-09-21 Impact factor: 2.228
Authors: Fred Poordad; Eugene R Schiff; John M Vierling; Charles Landis; Robert J Fontana; Rong Yang; Fiona McPhee; Eric A Hughes; Stephanie Noviello; Eugene S Swenson Journal: Hepatology Date: 2016-03-07 Impact factor: 17.425
Authors: Francesca Romana Ponziani; Francesca Mangiola; Cecilia Binda; Maria Assunta Zocco; Massimo Siciliano; Antonio Grieco; Gian Lodovico Rapaccini; Maurizio Pompili; Antonio Gasbarrini Journal: World J Hepatol Date: 2017-03-08