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- Title
Bridging all oral DAA therapy from wait time to post-liver transplant to improve HCV eradication?
- Authors
Donato, Maria Francesca; Monico, Sara; Malinverno, Federica; Aghemo, Alessio; Maggioni, Marco; Reggiani, Paolo; Colombo, Massimo
- Abstract
Background & Aims: Recurrence of hepatitis C is a major cause of graft loss and shortened survival in patients receiving a liver transplant ( LT) for end-stage hepatitis C virus ( HCV) infection. The only way to improve graft and patient outcomes is a successful eradication of HCV infection by antiviral therapy either before or after transplant. This was achievable in a small proportion of recipients by IFN-based regimens, but could be obtained in the majority of them by using DAA IFN-free regimens before/after transplant. Methods: We describe a patient with decompensated cirrhosis because of severe recurrent hepatitis C, who had a retransplant following treatment with a combination of sofosbuvir and riba virin that started during the waiting time and was carried over during both the transplant and post-transplant phases for an overall period of 24 weeks. The patient gave a written consent to receive Sofosbuvir plus Rbv therapy pre and post-transplant. Results: Post-transplant serum HCV- RNA remains undetectable 24 weeks after discontinuing sofosbuvir and ribavirin ( SVR24). Conclusions: Waiting for direct antiviral agents combinations, our findings not only support the use of sofosbuvir plus ribavirin as the first-line treatment in all patients on the LT waiting list, but also suggest to bridge treatment to the post-transplant period in case HCV RNA undetectability for at least 30 days has not been achieved at the time of LT.
- Subjects
LIVER cancer; CARCINOMA; LIVER diseases; LIVER failure; MULTIVARIATE analysis
- Publication
Liver International, 2015, Vol 35, Issue 1, p1
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.12646