Decline of HCV RNA and Core Antigen: Predictors of Achieving SVR in Transplant Recipients Undergoing DAA-Therapy.

S. Pischke,³ V. Proske,¹ S. Polywka,⁴ M. Lütgehetmann,⁴ M. Lang,¹ S. Stauga,¹ L. Fischer,¹ A. Lohse,³ B. Nashan,² M. Sterneck.¹

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 May 11, 2025.

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