Sofosbuvir in combination with daclatasvir in liver transplant recipients with HCV infection: A systematic review and meta-analysis

Background: Studies focusing on the efficacy of SOF + DCV regimen on liver transplantation recipients with HCV infection are still limited. In the current study, we aimed to perform a systematic review and meta-analysis to evaluate the efficacy and tolerability of SOF + DCV regimen, with or without ribavirin, on post-LT setting. Methods: A systematic literature search of various databases as well as abstracts of major liver diseases conferences was performed. Studies with SVR data in HCV infected liver transplantation recipients treated with daclatasvir/sofosbuvir regimen were included. All statistical analyses were conducted by R version 3.3.1 (The R Foundation for Statistical Computing, Vienna, Austria). Results: Seven studies with a total of 379 LT recipients were included in this study. Most of these LT recipients had genotype 1 HCV infection. The overall rate of SVR12 reached 93.3% (95% CI: 83.3% to 99.4%). After excluding the study of Fontana et al., the SVR12 reached 96.8% and heterogeneity was lowered down (P = 0.17). In three studies, patients treated with SOF + DCV (n = 146) had a higher SVR12 rate than that of patients treated with SOF + DCV + RBV (n = 83) (OR 0.33, 95% CI: 0.12 to 0.87; P = 0.02).with HCV genotype 1 and genotype 3 (P = 0.57) and no difference was found in SVR12 ratebetween 12-week therapy and 24-week therapy (P = 0.82). The most common adverse effects(AEs) were: anemia 32% (n = 64/202), infections 26% (n = 38/149), neutropenia 23% (n = 35/149), thrombocytopenia 21% (n = 32/149) and renal failure 8% (n = 12/149). There was no difference in SVR12 between patients infected Conclusion: SOF + DCV +/- RBV regimen is of high efficacy and tolerability in LT recipients withHCV infection. (C) 2016 Elsevier Masson SAS. All rights reserved.