Direct-Acting Antivirals in the Treatment of Hepatitis C Virus Recurrence after Liver Transplantation: Real-life Experience in a Mexican Cohort

Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA)...

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Veröffentlicht in:	Archives of medical research Jg. 52; H. 7; S. 713 - 718
Hauptverfasser:	Kauffman-Ortega, Eric, Ruiz-Manriquez, Jesus, Olivas-Martinez, Antonio, Campos-Murguía, Alejandro, Flores-García, Nayelli C, Márquez-Guillén, Ernesto, López-Yáñez, Silvia, Sánchez-Ávila, Francisco, Toapanta-Yanchapaxi, Liz, Paez-Zayas, Victor M, García-Juárez, Ignacio
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Elsevier Inc 01.10.2021
Schlagworte:	Antiviral Agents - therapeutic use Cohort Studies Direct-acting antivirals Hepacivirus - genetics Hepatitis C - drug therapy Hepatitis C virus Hepatitis C, Chronic - drug therapy Humans Liver transplant Liver Transplantation Recurrence Retrospective Studies Treatment Outcome Liver transplant Hepatitis C virus Direct-acting antivirals
ISSN:	0188-4409, 1873-5487, 1873-5487
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Abstract	Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA) is highly effective and safe in this population. To describe the efficacy and safety of DAA in treating post LT HCV recurrence in a Mexican cohort. Methods: We designed a retrospective cohort study that included all LT patients from 2000–2019 with HCV recurrence after LT who received DAA. Clinical and biochemical characteristics were collected from clinical records. Patients who received treatment before LT and those who received interferon-based therapies after LT achieving sustained viral response at 12 weeks were excluded; patients who didn´t complete DAA therapy were eliminated. The primary outcome was SVR-12. Results: Fifty-six patients received DAA after the LT with 98% SVR-12. The most frequent genotypes were 1b (54%) and 1a (34%). The most common antiviral scheme used was sofosbuvir/ledipasvir for 12 weeks in 59% of the patients. No severe adverse effects were observed. Ribavirin was used in 82% of the patients, of which 23.9% had adverse effects, mostly mild. The median follow-up after LT was 55 months (IQR 43-51), with a global and graft survival at one and three years of 100%. Conclusion: In a Mexican cohort, DAA therapy in LT patients with recurrence of HCV infection showed high efficacy and an acceptable safety profile.
AbstractList	Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA) is highly effective and safe in this population. To describe the efficacy and safety of DAA in treating post LT HCV recurrence in a Mexican cohort. Methods: We designed a retrospective cohort study that included all LT patients from 2000–2019 with HCV recurrence after LT who received DAA. Clinical and biochemical characteristics were collected from clinical records. Patients who received treatment before LT and those who received interferon-based therapies after LT achieving sustained viral response at 12 weeks were excluded; patients who didn´t complete DAA therapy were eliminated. The primary outcome was SVR-12. Results: Fifty-six patients received DAA after the LT with 98% SVR-12. The most frequent genotypes were 1b (54%) and 1a (34%). The most common antiviral scheme used was sofosbuvir/ledipasvir for 12 weeks in 59% of the patients. No severe adverse effects were observed. Ribavirin was used in 82% of the patients, of which 23.9% had adverse effects, mostly mild. The median follow-up after LT was 55 months (IQR 43-51), with a global and graft survival at one and three years of 100%. Conclusion: In a Mexican cohort, DAA therapy in LT patients with recurrence of HCV infection showed high efficacy and an acceptable safety profile. Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA) is highly effective and safe in this population.BACKGROUNDHepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA) is highly effective and safe in this population.To describe the efficacy and safety of DAA in treating post LT HCV recurrence in a Mexican cohort.AIM OF THE STUDYTo describe the efficacy and safety of DAA in treating post LT HCV recurrence in a Mexican cohort.We designed a retrospective cohort study that included all LT patients from 2000-2019 with HCV recurrence after LT who received DAA. Clinical and biochemical characteristics were collected from clinical records. Patients who received treatment before LT and those who received interferon-based therapies after LT achieving sustained viral response at 12 weeks were excluded; patients who didn´t complete DAA therapy were eliminated. The primary outcome was SVR-12.METHODSWe designed a retrospective cohort study that included all LT patients from 2000-2019 with HCV recurrence after LT who received DAA. Clinical and biochemical characteristics were collected from clinical records. Patients who received treatment before LT and those who received interferon-based therapies after LT achieving sustained viral response at 12 weeks were excluded; patients who didn´t complete DAA therapy were eliminated. The primary outcome was SVR-12.Fifty-six patients received DAA after the LT with 98% SVR-12. The most frequent genotypes were 1b (54%) and 1a (34%). The most common antiviral scheme used was sofosbuvir/ledipasvir for 12 weeks in 59% of the patients. No severe adverse effects were observed. Ribavirin was used in 82% of the patients, of which 23.9% had adverse effects, mostly mild. The median follow-up after LT was 55 months (IQR 43-51), with a global and graft survival at one and three years of 100%.RESULTSFifty-six patients received DAA after the LT with 98% SVR-12. The most frequent genotypes were 1b (54%) and 1a (34%). The most common antiviral scheme used was sofosbuvir/ledipasvir for 12 weeks in 59% of the patients. No severe adverse effects were observed. Ribavirin was used in 82% of the patients, of which 23.9% had adverse effects, mostly mild. The median follow-up after LT was 55 months (IQR 43-51), with a global and graft survival at one and three years of 100%.In a Mexican cohort, DAA therapy in LT patients with recurrence of HCV infection showed high efficacy and an acceptable safety profile.CONCLUSIONIn a Mexican cohort, DAA therapy in LT patients with recurrence of HCV infection showed high efficacy and an acceptable safety profile. Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT universally develop recurrent HCV in the allograft, leading to accelerated fibrosis and graft loss. Treatment with direct-acting antivirals (DAA) is highly effective and safe in this population. To describe the efficacy and safety of DAA in treating post LT HCV recurrence in a Mexican cohort. We designed a retrospective cohort study that included all LT patients from 2000-2019 with HCV recurrence after LT who received DAA. Clinical and biochemical characteristics were collected from clinical records. Patients who received treatment before LT and those who received interferon-based therapies after LT achieving sustained viral response at 12 weeks were excluded; patients who didn´t complete DAA therapy were eliminated. The primary outcome was SVR-12. Fifty-six patients received DAA after the LT with 98% SVR-12. The most frequent genotypes were 1b (54%) and 1a (34%). The most common antiviral scheme used was sofosbuvir/ledipasvir for 12 weeks in 59% of the patients. No severe adverse effects were observed. Ribavirin was used in 82% of the patients, of which 23.9% had adverse effects, mostly mild. The median follow-up after LT was 55 months (IQR 43-51), with a global and graft survival at one and three years of 100%. In a Mexican cohort, DAA therapy in LT patients with recurrence of HCV infection showed high efficacy and an acceptable safety profile.
Author	Ruiz-Manriquez, Jesus García-Juárez, Ignacio Paez-Zayas, Victor M Campos-Murguía, Alejandro Flores-García, Nayelli C López-Yáñez, Silvia Kauffman-Ortega, Eric Toapanta-Yanchapaxi, Liz Olivas-Martinez, Antonio Márquez-Guillén, Ernesto Sánchez-Ávila, Francisco
Author_xml	– sequence: 1 givenname: Eric surname: Kauffman-Ortega fullname: Kauffman-Ortega, Eric organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 2 givenname: Jesus orcidid: 0000-0002-4012-0942 surname: Ruiz-Manriquez fullname: Ruiz-Manriquez, Jesus organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 3 givenname: Antonio orcidid: 0000-0003-2779-0068 surname: Olivas-Martinez fullname: Olivas-Martinez, Antonio organization: Department of Biostatistics, University of Washington, Seattle, Washington – sequence: 4 givenname: Alejandro surname: Campos-Murguía fullname: Campos-Murguía, Alejandro organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 5 givenname: Nayelli C surname: Flores-García fullname: Flores-García, Nayelli C organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 6 givenname: Ernesto surname: Márquez-Guillén fullname: Márquez-Guillén, Ernesto organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 7 givenname: Silvia surname: López-Yáñez fullname: López-Yáñez, Silvia organization: Departamento de Trabajo Social de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México – sequence: 8 givenname: Francisco orcidid: 0000-0002-4636-9028 surname: Sánchez-Ávila fullname: Sánchez-Ávila, Francisco organization: Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Nuevo León, México – sequence: 9 givenname: Liz orcidid: 0000-0002-1218-1721 surname: Toapanta-Yanchapaxi fullname: Toapanta-Yanchapaxi, Liz organization: Clínica de Enfermedades Neuromusculares, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México – sequence: 10 givenname: Victor M surname: Paez-Zayas fullname: Paez-Zayas, Victor M organization: Departamento de Trasplante de Órganos, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, México – sequence: 11 givenname: Ignacio surname: García-Juárez fullname: García-Juárez, Ignacio email: drinter77@gmail.com organization: Unidad de Hepatología y Trasplante de Hígado, Departamento de Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, México
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Keywords	Liver transplant Hepatitis C virus Direct-acting antivirals
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Snippet	Hepatitis C virus (HCV) infection is one of the most frequent causes of liver transplantation (LT) worldwide. Patients with HCV viremia at the time of LT...
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SubjectTerms	Antiviral Agents - therapeutic use Cohort Studies Direct-acting antivirals Hepacivirus - genetics Hepatitis C - drug therapy Hepatitis C virus Hepatitis C, Chronic - drug therapy Humans Liver transplant Liver Transplantation Recurrence Retrospective Studies Treatment Outcome
Title	Direct-Acting Antivirals in the Treatment of Hepatitis C Virus Recurrence after Liver Transplantation: Real-life Experience in a Mexican Cohort
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