Vinaixa C, Berenguer M

Language: English
References: 7
Page: 322-323
PDF size: 101.38 Kb.

Text Extraction

In the field of hepatitis C treatment, currently almost all past issues are solved, including treatment of special populations. Nevertheless, some aspects remain unanswered, such as the controversial decision to treat pre vs. post-liver transplantation (LT), the “point of no return” for improvement of hepatic function after antiviral treatment, and optimizing treatment outcomes in some subgroups like genotype 3 infection in hemodialysis patients. We read with interest the article by Eric M. Yoshida, et al., which is a post-hoc analysis of the persistence of viral response (pTVR) after LT in patients included in the SOLAR trials who received antiviral treatment and subsequently underwent LT. In the study by Yoshida, et al., all 17 were decompensated cirrhotic patients (Child B or C) with median MELD score of 16 who started treatment with Ledipasvir/Sofosbuvir plus ribavirin (RBV) before LT. Of these, 10 patients completed their planned treatment duration before LT, while 7 underwent LT before completing the 12 or 24 weeks of planned antiviral treatment. Seventy-six percent of patients completed at least 12 weeks of antiviral treatment. As a result, all 17 patients achieved pTVR, although one died shortly after LT (unrelated to study drugs), leading to a 94% rate of pTVR-12.

REFERENCES

1. Charlton M, Everson GT, Flamm SL, Kumar P, Landis C, Brown RS Jr, Fried MW, et al. Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease. Gastroenterology 2015; 149: 649- 659. doi:10.1053/j.gastro.2015.05.010.

2. Manns M, Samuel D, Gane EJ, Mutimer D, McCaughan G, Buti M, Prieto M, et al. Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open-label, randomised, phase 2 trial. Lancet Infect Dis 2016; 16: 685-97. doi:10.1016/S1473-309900052-9.

3. Everson GT, Terrault NA, Lok AS, Rodrigo del R, Brown RS Jr., Saab S, Shiffman ML, et al. A randomized controlled trial of pretransplant antiviral therapy to prevent recurrence of hepatitis C after liver transplantation. Hepatology 2013; 57: 1752-62. doi:10.1002/hep.25976.

4. Curry MP, Forns X, Chung RT, Terrault NA, Brown R Jr., Fenkel JM, Gordon F, et al. Sofosbuvir and ribavirin prevent recurrence of HCV infection after liver transplantation: An open-label study. Gastroenterology 2015; 148. doi:10.1053/ j.gastro.2014.09.023.

5. Donato MF, Morelli C, Romagnoli R, Invernizzi F, Mazzarelli C, Iemmolo RM, Montalbano M, et al. Prevention of hepatitis C recurrence by bridging sofosbuvir/ribavirin from pre- to post-liver transplant: A real-life strategy. Liver Int 2016. doi:10.1111/liv.13322.

6. Carrillo CF, Crespo G, de la Revilla J, Castells L, Buti M, Montero JL, Fábrega E, et al. Successful continuation of HCV treatment following liver transplantation. Transplantation 2016: 1. doi:10.1097/TP.0000000000001596.

7. Belli LS, Berenguer M, Cortesi PA, Strazzabosco M, Rockenschaub SR, Martini S, Morelli C, et al. Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: A European study. J Hepatol 2016; 65(3): 524-31.