Virological Response at 4 Weeks With a Sofosbuvir-Based Antiviral Regimen in Liver Transplant Recipients with Recurrent Hepatitis C.
T. Pastrana-Camacho,1 M. Bradley,1 H. Winters,1 S. Black,2 K. Porter,3 K. Mumtaz.4
1Pharmacy, The Ohio State University-Wexner Medical Center, Columbus, OH
2Department of Surgery, The Ohio State University-Wexner Medical Center, Columbus, OH
3Center for Biostatistics, The Ohio State University-Wexner Medical Center, Columbus, OH
4Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, The Ohio State University-Wexner Medical Center, Columbus, OH.
Meeting: 2016 American Transplant Congress
Abstract number: D294
Keywords: Calcineurin, Hepatitis C, Liver transplantation, Recurrence
Session Information
Session Name: Poster Session D: Viral Hepatitis
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: The literature is growing in the area of safety, efficacy and tolerability of sofosbuvir (SOF)- based antivirals therapy (AVT) in recurrent hepatitis C virus (HCV) post liver transplantation (LT). We aim to report the response after 4 weeks of SOF-based AVT defined as rapid virological response (RVR) in recurrent HCV infection. Methods: Single center cohort study of adult liver transplant recipients who received SOF-based AVT from Jan 2012 to Oct 2015. Primary end point was rapid viral response. We also studied the predictors of RVR.
Results: There were 41 LT performed for HCV during study period. Of these, 37 {90%; mean age: 60; IQR= 56-63 years, 30 (81%) males} with recurrent HCV infection were treated with SOF based AVT. Thirty-two were treated with SOF/ledipasvir and 5 with SOF/ribavirin. AVT was started within 12 months in 13 (35%) patients and in the rest (65%) ≥12 months after LT. A majority of patients (n=31; 83%) had genotype 1 infection (GT-1). Pretreatment mean HCV viremia was 4,000,000 copies/mL (IQR: 1,400,000- 7,500,000). High viremia (>6 million copies/mL) was reported in 11 (30%) patients. Overall 27/37 (76%) achieved RVR, while 24/31 (77%) with GT-1 achieved RVR. Among those who did not achieved RVR mean HCV viremia was <12 copies/mL (IQR= <12 to 26.5). On univariate analysis, predictors of RVR were cyclosporine use (n=18; 64%) as compared to tacrolimus (n=9; 32%), p=0.03. Another predictor was start of AVT ≥12 months post LT (p=0.02). Fatigue (20%) and insomnia (9%) were the most commonly reported adverse effects. No difference in genotype, MELD score or fibrosis score was observed between patients. Conclusions: RVR was achieved in 76% of patients;those not able to achieve RVR had very low viremia and expect to achieve SVR-12 and SVR-24. Predictors of RVR were use of cyclosporine and treatment ≥12 months post LT.
CITATION INFORMATION: Pastrana-Camacho T, Bradley M, Winters H, Black S, Porter K, Mumtaz K. Virological Response at 4 Weeks With a Sofosbuvir-Based Antiviral Regimen in Liver Transplant Recipients with Recurrent Hepatitis C. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Pastrana-Camacho T, Bradley M, Winters H, Black S, Porter K, Mumtaz K. Virological Response at 4 Weeks With a Sofosbuvir-Based Antiviral Regimen in Liver Transplant Recipients with Recurrent Hepatitis C. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/virological-response-at-4-weeks-with-a-sofosbuvir-based-antiviral-regimen-in-liver-transplant-recipients-with-recurrent-hepatitis-c/. Accessed November 8, 2024.« Back to 2016 American Transplant Congress