Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Hepatitis C infection is associated with worse clinical outcomes in kidney transplant recipients. Direct-acting antivirals (DAAs) have been effectively used in liver transplant patients but have not been studied in kidney transplant recipients.
Method: A retrospective chart review was performed on patients (pts) who completed HCV treatment (tx) with DAAs between December 2013 and October 2015. A total of 18 kidney transplant (KT) pts were identified, of which 8 pts had KT alone and 10 pts had kidney and orthotopic liver transplant (OLT). The primary outcome measure was sustained virologic response (SVR), defined as undetectable viral load at 3 months post-treatment. Secondary outcomes were change in kidney function, incidence of rejection and modification in immunosuppression doses while on treatment.
Results: Mean patient age was 58.2 ± 5.9, predominantly male (67%) and Caucasian (67%). Median time between kidney transplant to HCV tx was 84 months (7 to 456). Median viral load was 1.6 million copies/ml (0.023-15.5) and majority of patient (89%) were infected with genotype 1. All patients were on anti-metabolite (16/18 MMF and 2/18 Imuran) and majority of patients were on CNI (12/18 Tacrolimus and 3/18 cyclosporine). 89% (16/18) patients achieved SVR. None of the patients had acute rejection and mean serum creatinine remained unchanged(p=0.5). Tacrolimus dose increase was required in 5/13 pts and cyclosporine dose was decreased in 2/3. Treatment outcomes by transplant type are shown in table 1 and treatment response by treatment regimen is outlined in table 2. One patient had AKI secondary to cyclosporine toxicity and there were no other major adverse effects of treatment in any patient.
|Mean Cr before tx (± SD), mg/dL||1.28(0.5)||1.18(0.27)||1.23(0.38)|
|Mean Cr post tx (± SD), mg/dL||1.31(0.57)||1.16(0.23)||1.22(0.41)|
|Immunosuppression dose change, %||63(5/8)||20(2/10)||39(7/18)|
|Regimen||Harvoni (ledipasvir/sofosbuvir)||Simeprevir/sofosbuvir||Sofosbuvir/Ribavarin||Viekira Pak (ombitasvir/paritaprevir/ritonavir)|
Conclusion: Hepatitis C treatment with DAAs in kidney transplant patients appears to be safe and effective.
CITATION INFORMATION: Goyal N, Huepfel W, Tierney A, Issa N, Lake J, Thompson J, Hassan M, Ibrahim H, Kukla A. Direct-Acting Antivirals for Hepatitis C Treatment in Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Goyal N, Huepfel W, Tierney A, Issa N, Lake J, Thompson J, Hassan M, Ibrahim H, Kukla A. Direct-Acting Antivirals for Hepatitis C Treatment in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/direct-acting-antivirals-for-hepatitis-c-treatment-in-kidney-transplant-recipients/. Accessed November 23, 2020.
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