Background. With the development of direct-acting antivirals, the treatment of Hepatitis C Virus (HCV) has become a rapidly changing area of medical practice. Data on the use of the newer agents for the treatment of recurrent HCV infection post liver transplant (LT) is scanty. The SOLAR trial data showed good efficacy of the combination of ledipasvir/sofosbuvir (LDV/SOF) along with ribavirin (RBV) in post LT, however RBV is associated with significant adverse effects, including anemia. The purpose of this study was to evaluate the efficacy of LDV/SOF (without RBV) for patients with genotype 1 recurrent HCV infection post LT.

Methods. Single-center, IRB approved retrospective analysis of patients with recurrent HCV infection, genotype 1, post LT treated with LDV/SOF (without RBV) from October 2014 to October 2015. Patients were identified through hepatology clinic records. Data collection included genotype, prior and current HCV therapies, presence of cirrhosis, documented adverse effects from medications, and virologic response at 4 weeks, end of treatment (EOT), and 12 weeks post treatment completion (SVR12).

Results. A total of 68 patients met inclusion criteria with mean time from LT of 61 months. Baseline demographics demonstrated 87% Caucasian, 10% African American, and 3% Hispanic race. The mean age was 60 years. Over half of patients (54%) were treatment naïve. Only 10% had documented cirrhosis. A total of 78% (n=53) of patients received 12 week treatment duration, while 22%(n=15) received 24 week treatment duration. Currently, 87% (n=59) of patients have completed treatment for HCV, with additional patients pending. Data collection to date shows a 100% (48/48) EOT response (n=20 pending) and 100% (34/34) SVR12 (n=34 pending). No discontinuation of treatment due to adverse events occurred. Data collection is ongoing.

Conclusion. Treatment with LDV/SOF (without RBV) appears to have high efficacy in the treatment of recurrent HCV post LT with excellent tolerability. Additional SVR12 data will be reported at the time of the meeting.

CITATION INFORMATION: Jones D, Baggett S, Shoreibah M, Massoud O. Outcomes of Ribavirin Free Treatment of Recurrent Genotype 1 , Hepatitis C Infection Post Liver Transplant. Am J Transplant. 2016;16 (suppl 3).

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