Successful Treatment of Hepatitis C in Renal Transplant Recipients with Directly Acting Antiviral Agents.
1Transplantation, Albert Einstein College of Medicine, Bronx, NY
2Hepatology, Columbia Universtiy, New York, NY.
Meeting: 2016 American Transplant Congress
Abstract number: 398
Keywords: Hepatitis C, Kidney transplantation, Viral therapy
Session Information
Session Name: Concurrent Session: It's Just Not the Donor: Impact of Recipient Factors on Outcomes
Session Type: Concurrent Session
Date: Tuesday, June 14, 2016
Session Time: 2:30pm-4:00pm
Presentation Time: 2:30pm-2:42pm
Location: Ballroom A
Background: Hepatitis C infection (HCV) in kidney transplant (KTx) recipients has been shown to be a risk factor for decreased patient and allograft survival. With the development of new directly acting antiviral (DAA) medications, treatment of HCV in renal transplant recipients is possible, but limited data exists on its safety and efficacy in this population.
Methods: We performed a review of patients transplanted at our center with HCV treated with DAAs. Patients with at least 30 days of follow up were included (n=21). Primary endpoints included graft function and sustained virologic response (SVR), defined as negative viral load at 12 weeks post completion of therapy.
Results: Patient demographics are listed in Table 1. Median follow up was 200 days (range 90, 482) and median time from KTx to treatment was 1140 days (range 173,10404). After 12 weeks of therapy all 21 patients achieved negative viral load. There was no significant change in mean creatinine from start to completion of therapy (1.3±0.4 pre-DAA to 1.52±0.55 mg/dl post DAA, p=0.2). Both graft and patient survival at follow up was 100%. There were 15 patients with viral load data at 12 weeks post completion of therapy. Of those patients, 14 had achieved SVR (93.3%)
Conclusions: Our data demonstrates that DAAs can be used safely and effectively in patients after KTx. Longer follow up is needed determine the effects treatment has on graft and patient survival.
|
Characteristics |
N=21 |
|
Age (median, range) |
59 (37, 69) |
|
Sex |
16 Male |
|
Race |
8 Hispanic 6 Black/African American |
|
Type of Transplant |
19 Deceased donor 5 Dual Organ (3 combined liver-kidney, 2 kidney after liver) |
|
Induction Immunosupression |
10 Anti-Thymocyte Globulin, 9 simulect, 2 other |
|
Maintenance Immunosupression |
17 Prednisone, Tacrolimus, Mycophenolate |
|
HCV Genotype |
19 type 1 2 type 2 |
|
HCV donor status |
9 HCV positive (18 where data available) |
|
Prior Therapy |
15 treatment naïve |
|
Mean Viral Load at start of therapy |
5026609±6118863 |
|
Mean Creatinine at start of therapy |
1.3±0.4 |
|
Proteinuria at start of therapy |
0.8±1.2 |
|
Mean Creatinine at completion of therapy |
1.5±0.5 |
|
Proteinuria at completion of therapy |
0.7±0.7 |
|
Treatment regimen |
14 ledipasvir/sofosbuvir 4 sofosbuvir/ribavirin 2 ledipasvir/sofosbuvir/ribavirin 1 sofosbuvir/daclatasvir |
CITATION INFORMATION: Lubetzky M, Chun S, Joelson A, Akalin E, Gaglio P, DeBoccardo G. Successful Treatment of Hepatitis C in Renal Transplant Recipients with Directly Acting Antiviral Agents. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Lubetzky M, Chun S, Joelson A, Akalin E, Gaglio P, DeBoccardo G. Successful Treatment of Hepatitis C in Renal Transplant Recipients with Directly Acting Antiviral Agents. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/successful-treatment-of-hepatitis-c-in-renal-transplant-recipients-with-directly-acting-antiviral-agents/. Accessed November 21, 2024.« Back to 2016 American Transplant Congress