Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center

Detalhes bibliográficos
Autor(a) principal: Zanaga,L.P.
Data de Publicação: 2019
Outros Autores: Santos,A.G., Ataíde,E.C., Boin,I.F.S.F., Stucchi,R.S.B.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Medical and Biological Research
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000800606
Resumo: Recurrent hepatitis C (HCV) after liver transplantation (LT) is an important cause of morbidity and mortality. Antiviral treatment is recommended to avoid unfavorable outcomes. Direct-acting antivirals (DAA) have transformed HCV treatment, with higher efficacy and fewer side-effects than interferon-based therapies traditionally used. To evaluate DAA treatment outcomes at a Brazilian transplant unit, data of patients who finished HCV treatment at the Liver Transplant Unit of the University of Campinas were analyzed. Treatment consisted of sofosbuvir, daclatasvir, and ribavirin, for 12 or 24 weeks, according to the national guidelines. Fifty-five patients completed antiviral treatment and 54 had HCV-viral load results available. The majority of patients were male (78%), 58 years old on average, 65% had hepatocellular carcinoma (HCC) before LT, and 67% were interferon treatment-experienced. Most patients had HCV genotype 1 (65%), 35% had genotype 3, and started treatment on an average of 38 months after LT (range: 2–228). Fifty-eight percent were treated for 12 weeks and 42% for 24 weeks, using a mean dose of ribavirin of 10.1 mg/kg (4.2–16.1). There were no treatment interruptions due to serious side effects. The sustained virological response rate was 98%. Only one patient relapsed, a genotype 3 cirrhotic treated for 12 weeks. The average follow-up after starting antivirals was 20 months. There were no recurrences of HCC, but there was one rejection episode and one cirrhosis decompensation episode, both 12 weeks after treatment. DAA treatment is safe and effective in the post-LT setting and was not associated to HCC recurrence in the cohort studied.
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spelling Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant centerHepatitis CLiver transplantationDirect acting antiviralsSofosbuvirDaclatasvirRecurrent hepatitisRecurrent hepatitis C (HCV) after liver transplantation (LT) is an important cause of morbidity and mortality. Antiviral treatment is recommended to avoid unfavorable outcomes. Direct-acting antivirals (DAA) have transformed HCV treatment, with higher efficacy and fewer side-effects than interferon-based therapies traditionally used. To evaluate DAA treatment outcomes at a Brazilian transplant unit, data of patients who finished HCV treatment at the Liver Transplant Unit of the University of Campinas were analyzed. Treatment consisted of sofosbuvir, daclatasvir, and ribavirin, for 12 or 24 weeks, according to the national guidelines. Fifty-five patients completed antiviral treatment and 54 had HCV-viral load results available. The majority of patients were male (78%), 58 years old on average, 65% had hepatocellular carcinoma (HCC) before LT, and 67% were interferon treatment-experienced. Most patients had HCV genotype 1 (65%), 35% had genotype 3, and started treatment on an average of 38 months after LT (range: 2–228). Fifty-eight percent were treated for 12 weeks and 42% for 24 weeks, using a mean dose of ribavirin of 10.1 mg/kg (4.2–16.1). There were no treatment interruptions due to serious side effects. The sustained virological response rate was 98%. Only one patient relapsed, a genotype 3 cirrhotic treated for 12 weeks. The average follow-up after starting antivirals was 20 months. There were no recurrences of HCC, but there was one rejection episode and one cirrhosis decompensation episode, both 12 weeks after treatment. DAA treatment is safe and effective in the post-LT setting and was not associated to HCC recurrence in the cohort studied.Associação Brasileira de Divulgação Científica2019-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000800606Brazilian Journal of Medical and Biological Research v.52 n.8 2019reponame:Brazilian Journal of Medical and Biological Researchinstname:Associação Brasileira de Divulgação Científica (ABDC)instacron:ABDC10.1590/1414-431x20198519info:eu-repo/semantics/openAccessZanaga,L.P.Santos,A.G.Ataíde,E.C.Boin,I.F.S.F.Stucchi,R.S.B.eng2019-08-02T00:00:00Zoai:scielo:S0100-879X2019000800606Revistahttps://www.bjournal.org/https://old.scielo.br/oai/scielo-oai.phpbjournal@terra.com.br||bjournal@terra.com.br1414-431X0100-879Xopendoar:2019-08-02T00:00Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)false
dc.title.none.fl_str_mv Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
title Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
spellingShingle Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
Zanaga,L.P.
Hepatitis C
Liver transplantation
Direct acting antivirals
Sofosbuvir
Daclatasvir
Recurrent hepatitis
title_short Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
title_full Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
title_fullStr Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
title_full_unstemmed Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
title_sort Recurrent hepatitis C treatment with direct acting antivirals – a real life study at a Brazilian liver transplant center
author Zanaga,L.P.
author_facet Zanaga,L.P.
Santos,A.G.
Ataíde,E.C.
Boin,I.F.S.F.
Stucchi,R.S.B.
author_role author
author2 Santos,A.G.
Ataíde,E.C.
Boin,I.F.S.F.
Stucchi,R.S.B.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Zanaga,L.P.
Santos,A.G.
Ataíde,E.C.
Boin,I.F.S.F.
Stucchi,R.S.B.
dc.subject.por.fl_str_mv Hepatitis C
Liver transplantation
Direct acting antivirals
Sofosbuvir
Daclatasvir
Recurrent hepatitis
topic Hepatitis C
Liver transplantation
Direct acting antivirals
Sofosbuvir
Daclatasvir
Recurrent hepatitis
description Recurrent hepatitis C (HCV) after liver transplantation (LT) is an important cause of morbidity and mortality. Antiviral treatment is recommended to avoid unfavorable outcomes. Direct-acting antivirals (DAA) have transformed HCV treatment, with higher efficacy and fewer side-effects than interferon-based therapies traditionally used. To evaluate DAA treatment outcomes at a Brazilian transplant unit, data of patients who finished HCV treatment at the Liver Transplant Unit of the University of Campinas were analyzed. Treatment consisted of sofosbuvir, daclatasvir, and ribavirin, for 12 or 24 weeks, according to the national guidelines. Fifty-five patients completed antiviral treatment and 54 had HCV-viral load results available. The majority of patients were male (78%), 58 years old on average, 65% had hepatocellular carcinoma (HCC) before LT, and 67% were interferon treatment-experienced. Most patients had HCV genotype 1 (65%), 35% had genotype 3, and started treatment on an average of 38 months after LT (range: 2–228). Fifty-eight percent were treated for 12 weeks and 42% for 24 weeks, using a mean dose of ribavirin of 10.1 mg/kg (4.2–16.1). There were no treatment interruptions due to serious side effects. The sustained virological response rate was 98%. Only one patient relapsed, a genotype 3 cirrhotic treated for 12 weeks. The average follow-up after starting antivirals was 20 months. There were no recurrences of HCC, but there was one rejection episode and one cirrhosis decompensation episode, both 12 weeks after treatment. DAA treatment is safe and effective in the post-LT setting and was not associated to HCC recurrence in the cohort studied.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000800606
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/1414-431x20198519
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eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
dc.source.none.fl_str_mv Brazilian Journal of Medical and Biological Research v.52 n.8 2019
reponame:Brazilian Journal of Medical and Biological Research
instname:Associação Brasileira de Divulgação Científica (ABDC)
instacron:ABDC
instname_str Associação Brasileira de Divulgação Científica (ABDC)
instacron_str ABDC
institution ABDC
reponame_str Brazilian Journal of Medical and Biological Research
collection Brazilian Journal of Medical and Biological Research
repository.name.fl_str_mv Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)
repository.mail.fl_str_mv bjournal@terra.com.br||bjournal@terra.com.br
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