BACKGROUND: The treatment of HCV is one of the most rapidly changing areas of medical practice. These agents have been shown to be safe and effective for the treatment of HCV, and can be used in combination with previous standards of care. The benefits include patients with certain genotypes may avoid interferon therapy, a major cause of side effects and discontinuation of treatment. The newer agents allow for shortened treatment durations with certain genotypes, and the rate of sustained virologic response (SVR) is significantly higher with these agents. Although literature and guidelines support the use of these new agents in combination, research is limited in special patient populations, including post-liver transplant. The purpose of this study is to evaluate the current standards of practice and the rate of SVR in patients after liver transplant.

METHODS: Retrospective, observational electronic medical record review evaluating liver transplant recipients initiated on HCV treatment from December 2013 to December 2014. Patients were identified through hospital records and were transplanted and treated at our academic medical center. Treatment regimens evaluated include sofosbuvir, simeprevir, ledipasvir, ribavirin, and peginterferon alfa. Data collection included genotype, previous HCV therapies, presence of cirrhosis, current treatment regimen, virologic response at 1, 3, 6 months after treatment initiation, and any alterations in transplant medications. They will be evaluated immediately prior to HCV initiation, at defined monthly intervals of 1, 3, 6 months through treatment, and at completion of therapy. Follow up at 12 and 24 weeks post HCV treatment completion will include evaluation of SVR.

RESULTS: Data collection is ongoing. Based on current data, baseline demographics are similar throughout the treatment groups. Currently, 50 patients have initiated treatment for HCV, with additional patients pending. Patients averaged 59 years old, with 10% African American, 2% Hispanic, and 88% Caucasian race. Of the patients evaluated, 77% are genotype 1, 13% genotype 2, and 10% genotype 3. The most common treatment regimen is the combination of sofosbuvir and simeprevir (62%), with 89% of patients receiving 12 weeks of treatment compared to 11% receiving 24 weeks treatment. Continued data collection will follow each patient to 12 and 24 weeks after completion of therapy.

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