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Arch Med Res ; 53(6): 585-593, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36114037

RESUMO

BACKGROUND: Data concerning hepatitis C virus (HCV) treatment using direct-acting agents (DAAs) post liver transplantation (LT) remains scarce in low- and average-income countries. AIM OF THE STUDY: To evaluate the safety and efficacy of post-LT HCV treatment using DAAs in Rio de Janeiro (Brazil), and to assess the course of hepatic biomarkers after sustained virological response (SVR). METHODS: Data from LT recipients with recurrent HCV treated using DAAs was retrospectively analyzed. HCV was defined by detectable HCV-RNA with elevated aminotransferases and/or histological signs of infection on liver biopsy post LT. SVR was defined as undetectable HCV-RNA 12 weeks after the end of treatment. Aspartate-to-Platelet Ratio Index (APRI) and Fibrosis-4 score (FIB-4) were calculated before treatment and after SVR. RESULTS: 116 patients (63% male, median age 62 years, 75% genotype 1 and 62% with hepatocellular carcinoma [HCC] prior to LT) were included. Cirrhosis was identified in the allograft of 21 subjects (18%). The overall SVR was 96.6% without differences in SVR proportion according to clinical/demographic characteristics, genotype or presence of cirrhosis. SVR rates were similar in individuals with and without HCC pre-LT (95.8% [95% CI: 87.6-98.7] vs. 97.7% [95% CI: 85.0-99.7%], p = 0.588). No serious adverse events were observed and the use of ribavirin was associated with at least one adverse event (OR = 8.71 [95% CI: 3.17-23.99]). SVR was associated with regression of APRI (OR = 26.00 [95% CI 4.27-1065.94]) and FIB-4 (OR = 15.00 [95% CI: 2.30-631.47]). CONCLUSION: Post-LT HCV treatment with DAAs was safe and effective and associated with a significant decrease in hepatic biomarker levels after SVR.


Assuntos
Carcinoma Hepatocelular , Hepatite C , Neoplasias Hepáticas , Transplante de Fígado , Antivirais/uso terapêutico , Ácido Aspártico/uso terapêutico , Biomarcadores , Brasil , Carcinoma Hepatocelular/complicações , Feminino , Hepacivirus/genética , Hepatite C/complicações , Hepatite C/diagnóstico , Hepatite C/tratamento farmacológico , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/etiologia , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , RNA/uso terapêutico , Estudos Retrospectivos , Ribavirina/uso terapêutico , Transaminases/uso terapêutico
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