Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
- Time Course of Hepatic Graft Function Improvement After Ledipasivir/Sofosbuvir Treatment in Liver Transplant Recipients with HCV and Fibrosis or Cirrhosis Who Achieved SVR.
- Safety and Efficacy of Ledipasvir/Sofosbuvir (LS) with or without Ribavirin (RBV) for Treatment of Recurrent Hepatitis C Infection Post-Liver Transplant.
Background: Combination antiviral therapy involving Sofosbuvir (SOF) & Simeprevir (SIM) +/- Ribavirin (RBV) is a relatively safe & effective Tx option in pts with gen 1 chronic hepatitis C cirrhosis including those with decompensated cirrhosis.1 It is perceived that achieving sustained virologic response (SVR) will result in improvement in liver function & in some cases obviate the need for a liver transplant. However, data to prove that theory is lacking.
Aim: To determine clinical outcomes & change in Child Pugh (CP) scores in gen 1 pts with cirrhosis 1 year after completing Tx with SIM+SOF +/- RBV
Methods: Complete 1 year follow up data on pts that reached end of treatment (EOT) time point in Oct 2014 from a combined Tx cohort of 4 hepatology referral centers were collected. All (n=86) pts included in the analysis were cirrhotics & received SOF 400 mg daily + SIM 150 mg daily +/- wt based RBV , for 12 or 24 weeks at the discretion of the hepatologist.
Results: Of the 86 pts in the cohort, 65% were male, & 65% had genotype 1a. 29 (34%) had compensated Child's class A cirrhosis at baseline & 57 (66%) had decompensated CP B/C cirrhosis. 74% (64/86) achieved SVR12 & only 1 pt died from sepsis 4 weeks after EOT. Of the 64 pts who achieved SVR, 39% had improvement in CP score: 1 pt improved from CP C to A, 5 from CP C to B & 19 from B to A. 37/64 (58%) did not have any change & only 2 had worsening of CP score. Of those who did not achieve SVR, 15/22 (68%) had no change in CP score, 1 died, 1 had worsening of CP score & 5/22 (23%) had an improvement in CP score: 4 pts from CP B to A & 1 from C to B. From the time period after EOT to Oct 31, 2015, none underwent liver transplantation, 6% (5/86) pts req hospitalization, 23% (20/86) had at least 1 epi of HE, 22% (19/86) had an epi of fluid overload, & 2% (2/86) dev HCC.
Conclusion: All oral combination Tx of SOF + SIM +/- RBV leads to an improvement in CP scores 1 year after EOT in 1/3 of pts with cirrhosis especially in those who attained SVR12. This supports the theory that SVR leads to improvement in liver function even in those with decompensated cirrhosis & eventually may reduce the need for a liver transplant.
CITATION INFORMATION: Modi A, Hermann J, Nazario H, Gonzalez S, Gripshover J, Gautam M, Weinstein J, Potosky D, Barnes M, Habib A, Mantry P, Trotter J. Is SVR Associated with Improved Hepatic Function in Hepatitis C Gen 1 Pts with Cirrhosis 1 Year After Completing Treatment with Sofosbuvir + Simeprevir +/- Ribavirin? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Modi A, Hermann J, Nazario H, Gonzalez S, Gripshover J, Gautam M, Weinstein J, Potosky D, Barnes M, Habib A, Mantry P, Trotter J. Is SVR Associated with Improved Hepatic Function in Hepatitis C Gen 1 Pts with Cirrhosis 1 Year After Completing Treatment with Sofosbuvir + Simeprevir +/- Ribavirin? [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/is-svr-associated-with-improved-hepatic-function-in-hepatitis-c-gen-1-pts-with-cirrhosis-1-year-after-completing-treatment-with-sofosbuvir-simeprevir-ribavirin/. Accessed January 19, 2018.
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