Single-Center Initial Experience in Treating Chronic Hepatitis C in Kidney Transplant Recipients.
G. Meinerz, C. da Silva, R. Bruno, E. Keitel, V. Garcia.
Nephrology and Kidney Transplant Department, ISCMPA, Porto Alegre, RS, Brazil
Meeting: 2017 American Transplant Congress
Abstract number: A295
Keywords: Adverse effects, Hepatitis C, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session A: Viral Conundrums
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Chronic hepatitis C (HCV) infection is a prevalent condition in end-stage renal disease and presents an important clinical challenge in kidney transplant recipients (KTR). Interferon-based therapies have shown low efficacy and tolerability and high risk of rejection episodes. In this report, we describe the initial results of a single center experience with new direct antiviral agents (DAA) in KTR, regarding response, tolerability and complications. Results: A total of 15 kidney transplant recipients with HCV infection initiated sofosbuvir-based treatment in our center, 8 already completed treatment, 6 are still receiving medication and one discontinued (worsening renal function due to unrelated clinical complications). Characteristics from the 8 patients that completed treatment are presented in Table 1. Six patients (75%) received sofosbuvir and daclatasvir for 12 weeks, one (12.5%) for 24 weeks, and one (12.5%) received sofosbuvir, daclatasvir and ribavirin for 12 weeks. Five (62.5%) patients were receiving calcineurin-inhibitors, and no dose adjustments were necessary. Treatment was generaly well tolerated, with one case of symptomatic anemia (in a patient receiving ribavirin) that did not required hemotransfusion, and two patients presenting tachycardia that did not required intervention. One patient presented an acute rejection episode after the treatment completion that was not attributed to therapy but occurred in a context of low immunosuppression. Conclusion: HCV treatment with DAAs was well tolerated in KTR, with undetectable viral load by the end of therapy in all patients. This is an initial experience report but presents encouraging results for the kidney transplant population.
Characteristics | N=8 |
Median age (yr) | 53.5 (35-61) |
Female Gender | 5 (62.5%) |
Caucasian | 4 (50%) |
Previous IFN-treatment failure | 2 (25%) |
Cirrhosis | 1 (12.5%) |
Genotype
1a/1b 2 3 not registered |
3 (37.5%)
1 (12.5%) 3 (37.5% 1 (12.5%) |
Median time from transplantation (months) | 108.0 (32-476) |
Mean eGFR (min-max, mL/min/1.73m2)a
baseline week 4 week 8 week 12 |
61.6 (19.8-110.8)
55.2 (17.0-110.8) 52.6 (14.8-98.5) 57.2 (16.3-112.6) |
Mean viral load (min-max, log)
baseline end of treatment week 12 post-treatment |
6.01 (5.4-6.8)
undetectable undetectable (2 patients) |
CITATION INFORMATION: Meinerz G, da Silva C, Bruno R, Keitel E, Garcia V. Single-Center Initial Experience in Treating Chronic Hepatitis C in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Meinerz G, Silva Cda, Bruno R, Keitel E, Garcia V. Single-Center Initial Experience in Treating Chronic Hepatitis C in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/single-center-initial-experience-in-treating-chronic-hepatitis-c-in-kidney-transplant-recipients/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress