DAA-based antiviral treatment of patients with chronic hepatitis C in the pre- and postkidney transplantation setting

被引：68

作者：

Beinhardt, Sandra ^{[1
]}

Al Zoairy, Ramona ^{[2
]}

Ferenci, Peter ^{[1
]}

Kozbial, Karin ^{[1
]}

Freissmuth, Clarissa ^{[1
]}

Stern, Rafael ^{[1
]}

St Attermayer, Albert Friedrich ^{[1
]}

Stauber, Rudolf

Strasser, Michael ^{[3
,4
]}

Zoller, Heinz ^{[2
]}

Watschinger, Bruno ^{[5
]}

Schmidt, Alice ^{[5
]}

Trauner, Michael ^{[1
]}

Hofer, Harald ^{[1
]}

Maieron, Andreas ^{[6
]}

机构：

[1] Med Univ Vienna, Div Gastroenterol & Hepatol, Dept Internal Med 3, Waehringer Guertel 18-20, A-1090 Vienna, Austria

[2] Med Univ Innsbruck, Div Gastroenterol & Hepatol, Dept Med 2, Innsbruck, Tirol, Austria

[3] Med Univ Graz, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria

[4] Paracelsus Med Univ Salzburg, Dept Gastroenterol & Hepatol, Salzburg, Austria

[5] Med Univ Vienna, Div Nephrol, Dept Internal Med 3, Vienna, Austria

[6] Elisabethinen Hosp, Dept Gastroenterol, Linz, Austria

来源：

TRANSPLANT INTERNATIONAL | 2016年 / 29卷 / 09期

关键词：

chronic kidney disease (CKD); dialysis; direct-acting antivirals (DAA); end-stage renal disease (ESRD); IFN-free; renal transplantation; TREATMENT-EXPERIENCED PATIENTS; GENOTYPE; INFECTION; VIRUS-INFECTION; KIDNEY-DISEASE; INCREASED RISK; SOFOSBUVIR; RIBAVIRIN;

D O I：

10.1111/tri.12799

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

DAA-based regimens for chronic hepatitis C infection encourage treatment of "difficult-to-treat" cohorts. This study investigated efficacy and safety of DAA-based regimens in HCV patients on dialysis or postkidney or liver/kidney transplantation. Twenty-five patients treated with DAA combinations were evaluated: 10 were on dialysis (eight: hemodialysis, two: peritoneal dialysis), eight were kidney transplant recipients, and seven were liver/kidney transplant recipients. Except for one patient treated with daclatasvir ([DCV]/60 mg/QD)/simeprevir ([SMV]/150 mg/QD), the others received sofosbuvir-based regimens ([SOF]; 400 mg/QD) combined with SMV: eight, DCV: 13 or either ledipasvir ([LDV] 90 mg/QD), ribavirin ([RBV]; weight based) or pegylated interferon/RBV. HCV-RNA was determined by Abbott RealTime (LLOQ]: 12 IU/ml) or Roche AmpliPrep/COBAS TaqMan assay (LLOQ: 15 IU/ml); treatment response evaluated every 4 weeks, at the end of treatment, and 4 and 12 weeks thereafter. Twenty-four (96%) patients achieved SVR 12/24 (ITT-analysis). Mean treatment duration was 15.1 +/- 5.1 weeks (+/- SD), and two patients terminated prematurely - both reached SVR12. Six patients were hospitalized due to complications of underlying disease. One patient achieved SVR24 but was re-infected (week 27). Kidney function remained stable; serum creatinine increased in only one patient - SOF was reduced to 400 mg/48 h. Treatment with DAA combinations in renally impaired HCV patients is highly effective and well tolerated. These findings call for further controlled trials and data from real-life cohorts.

引用

页码：999 / 1007

页数：9

共 36 条

[31]

Ram BK, 2015, J HEPATOL, V63, P763, DOI 10.1016/j.jhep.2015.06.004

[32] Transplanting Hepatitis C-Positive Kidneys [J].