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Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study
BACKGROUND. Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004590/ https://www.ncbi.nlm.nih.gov/pubmed/32095505 http://dx.doi.org/10.1097/TXD.0000000000000954 |
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author | González-Corvillo, Carmen Beneyto, Isabel Sánchez-Fructuoso, Ana Perelló, Manel Alonso, Angel Mazuecos, Auxiliadora Jiménez, Carlos Zárraga, Sofía Paul, Javier Lauzurica, Ricardo Hernández, Domingo Guirado, Luis Franco, Antonio Ruiz, Juan Carlos Llorente, Santiago Crespo, Marta Rodríguez-Benot, Alberto de Gracia Guindo, María del Carmen Díaz-Corte, Carmen Gentil, Miguel Ángel |
author_facet | González-Corvillo, Carmen Beneyto, Isabel Sánchez-Fructuoso, Ana Perelló, Manel Alonso, Angel Mazuecos, Auxiliadora Jiménez, Carlos Zárraga, Sofía Paul, Javier Lauzurica, Ricardo Hernández, Domingo Guirado, Luis Franco, Antonio Ruiz, Juan Carlos Llorente, Santiago Crespo, Marta Rodríguez-Benot, Alberto de Gracia Guindo, María del Carmen Díaz-Corte, Carmen Gentil, Miguel Ángel |
author_sort | González-Corvillo, Carmen |
collection | PubMed |
description | BACKGROUND. Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. METHODS. Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. RESULTS. Patients (N = 226) were mostly male (65.9%) aged 56.1 ± 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 ± 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 ± 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4–41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. CONCLUSIONS. Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function. |
format | Online Article Text |
id | pubmed-7004590 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-70045902020-02-24 Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study González-Corvillo, Carmen Beneyto, Isabel Sánchez-Fructuoso, Ana Perelló, Manel Alonso, Angel Mazuecos, Auxiliadora Jiménez, Carlos Zárraga, Sofía Paul, Javier Lauzurica, Ricardo Hernández, Domingo Guirado, Luis Franco, Antonio Ruiz, Juan Carlos Llorente, Santiago Crespo, Marta Rodríguez-Benot, Alberto de Gracia Guindo, María del Carmen Díaz-Corte, Carmen Gentil, Miguel Ángel Transplant Direct Kidney Transplantation BACKGROUND. Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. METHODS. Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. RESULTS. Patients (N = 226) were mostly male (65.9%) aged 56.1 ± 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 ± 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 ± 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4–41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. CONCLUSIONS. Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function. Wolters Kluwer Health 2019-11-18 /pmc/articles/PMC7004590/ /pubmed/32095505 http://dx.doi.org/10.1097/TXD.0000000000000954 Text en Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Kidney Transplantation González-Corvillo, Carmen Beneyto, Isabel Sánchez-Fructuoso, Ana Perelló, Manel Alonso, Angel Mazuecos, Auxiliadora Jiménez, Carlos Zárraga, Sofía Paul, Javier Lauzurica, Ricardo Hernández, Domingo Guirado, Luis Franco, Antonio Ruiz, Juan Carlos Llorente, Santiago Crespo, Marta Rodríguez-Benot, Alberto de Gracia Guindo, María del Carmen Díaz-Corte, Carmen Gentil, Miguel Ángel Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title | Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title_full | Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title_fullStr | Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title_full_unstemmed | Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title_short | Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study |
title_sort | direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis c virus infection in spain: a long-term prospective observational study |
topic | Kidney Transplantation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004590/ https://www.ncbi.nlm.nih.gov/pubmed/32095505 http://dx.doi.org/10.1097/TXD.0000000000000954 |
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