Decline of HCV RNA and Core Antigen: Predictors of Achieving SVR in Transplant Recipients Undergoing DAA-Therapy.
1University Transplant Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
2Department of Hepatobiliary Surgery and Transplantation, University Hospital Hamburg Eppendorf, Hamburg, Germany
3Department of Medicine, University Hospital Hamburg Eppendorf, Hamburg, Greece
4Department of Microbiology, University Hospital Hamburg Eppendorf, Hamburg, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: 267
Keywords: Hepatitis C, Liver transplantation
Session Information
Session Name: Concurrent Session: Viral Hepatitis
Session Type: Concurrent Session
Date: Monday, June 13, 2016
Session Time: 2:30pm-4:00pm
Presentation Time: 3:30pm-3:42pm
Location: Ballroom A
Background:
DAA-treatment of hepatitis C virus (HCV) re-infections in orthotopic liver transplant (OLT) recipients has been demonstrated to be safe and effective in controlled studies, but real-world data are scarce. Usually, monitoring of HCV-infections relies on HCV-PCR-testing. The HCV-core-antigen-assay (HCV-core-Ag) is a cheap and efficient alternative, but its value to predict treatment response in OLT-patients is still undetermined.
Methods:
All OLT-patients treated with DAA-regimens at the University-Hospital-Hamburg-Eppendorf between 02/2014 and 08/2015 were studied (n=39, 42 treatment courses). HCV-core-Ag (HCV Ag, Abbott, Germany, LloD 3 fmol/L) and HCV-RNA (PCR) (COBAS AmpliPrep/Cobas TaqMan HCV quantitative test v.2, Roche, Germany, LloD 15 IU/ml) were determined at each visit. Treatment endpoint was SVR 12, i.e. loss of viremia 12 weeks after EOT.
Results:
39/42 treatment courses (93%) led to SVR 12. Three patients experienced treatment failure under therapy with SOF/RBV and were successfully retreated with SOF/DAC/RBV or SOF/LDV/RBV. All 17 (100%) patients treated with SOF/LDV achieved SVR 12 as compared to 88% (n=22) of patients treated with other DAA- regimes. HCV-core-Ag tested negative after a mean of 2.7 weeks (range 2-12 other DAAs; 2-4 SOF/LDV), while PCR-tests became negative after a mean of 5.14 weeks (range 2-12). SVR 12 was associated with a short time interval between treatment start and HCV-core-Ag-negativity (p=0.008, Mann-Whitney-test) or HCV-PCR-negativity (p=0.02). No severe side effects were observed.
Conclusions:
DAA-treatment is highly efficient and well tolerated in OLT-recipients. There was no treatment failure in patients receiving SOF/LDV. HCV-core-Ag-loss and PCR-negativity were both predictors of SVR 12.
CITATION INFORMATION: Pischke S, Proske V, Polywka S, Lütgehetmann M, Lang M, Stauga S, Fischer L, Lohse A, Nashan B, Sterneck M. Decline of HCV RNA and Core Antigen: Predictors of Achieving SVR in Transplant Recipients Undergoing DAA-Therapy. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Pischke S, Proske V, Polywka S, Lütgehetmann M, Lang M, Stauga S, Fischer L, Lohse A, Nashan B, Sterneck M. Decline of HCV RNA and Core Antigen: Predictors of Achieving SVR in Transplant Recipients Undergoing DAA-Therapy. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/decline-of-hcv-rna-and-core-antigen-predictors-of-achieving-svr-in-transplant-recipients-undergoing-daa-therapy/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress