Post-Transplant HCV Recurrence Treatable with DAAs

Liver transplant does not always mean the end of a hepatitis infection. A California team has had success treating recurrent HCV with DAAs.

Patients who need liver transplants because they lost their own livers to hepatitis C are not out of danger of liver disease after a successful transplant.

Infection can recur and treatment to date has been challenging.

In a study presented at the International Liver Congress in Barcelona, a research team from Loma Linda University Medical Center’s Transplantation Institute, Loma Linda, CA, Khaled Salim, MD and colleagues said they have good results with using directing-acting antiviral on these recurrent infections.

The DAAs used were ledipasvir/sofosbuvir with and without ribavirin and as an alternative, sofosbuvir with ribavirin.

In their report the team said 50 patients with recurrent HCV post-transplant were treated with DAAs.

Thirty-two patients completed week 12 after treatment. Overall the SVR12 was 97%. All 24 patients with genotype 1 achieved SVR12. The rate in patients with GT2 or GT3 was 82%.

“Our single center experience in treating recurrent hepatitis C genotypes 1,2,and 3 after liver or live/kidney transplantation with LDV/SOF with or with RBV or SOF with RBV was well tolerated with excellent SVR12,” they concluded.

The mean age of patients was 59 and 69% were men.Slightly more than half (52%) were Hispanic, 44% were Caucasian and 2% were black.

Of the group, 92% had received livers, 6% liver-kidney donations, and 2% were re-transplant cases.