Clinical efficacy of direct-acting antiviral agents in treatment of patients with hepatitis C recurrence after liver transplantation / 临床肝胆病杂志

ABSTRACT

ObjectiveTo observe the clinical effect and safety of direct-acting antiviral agents (DAAs) in patients with hepatitis C recurrence after liver transplantation. MethodsFifteen patients who received liver transplantation in 302 Hospital of PLA from December 2014 to May 2015 were selected, and after treatment, the HCV RNA-positive patients were treated with DAAs. The patients with genotype 1b were treated with Harvoni (sofosbuvir 400 mg/d + ledipasvir 90 mg/d) or sofosbuvir 400 mg/d + daclatasvir 60 mg/d, and those with genotype 2a were treated with sofosbuvir 400 mg/d + ribavirin 900mg/d. The course of treatment was 12 weeks. The changes in clinical symptoms and signs and laboratory markers including routine blood test, liver function, and HCV RNA quantification were observed regularly. ResultsAmong the 15 patients with hepatitis C recurrence after liver transplantation, 14 achieved HCV RNA clearance within 1-4 weeks, and the shortest time to clearance was 5 days; one patient had a HCV RNA level of 5.6×10 IU/ml at week 4. At month 12 of treatment, all the patients achieved HCV RNA clearance, and at the end of treatment, all the patients achieved virologic response. At present, 14 patients had achieved sustained virologic response for 12 weeks, and the other patients were still in the follow-up stage; at present, 3 patients had achieved sustained virologic response for 24 weeks, and the other 12 patients were still in the follow-up stage. Side effects of the treatment were mainly headache (1 case), weakness (5 cases), and arthralgia (1 case). ConclusionDAAs can be used in the treatment of patients with hepatitis C recurrence after liver transplantation with minor side effects, tolerance, and definite curative effect. Long-term sustained virologic response requires further observation.