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Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?

Background: Direct-acting antiviral (DAA) agents for the treatment of hepatitis C virus (HCV) infection have been proven safe and effective in cirrhotic patients awaiting liver transplantation (LT). However, in the long term, data remain minimal regarding the clinical impact of viral eradication on...

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Autores principales: Meunier, Lucy, Belkacemi, Mohamed, Pageaux, George Philippe, Radenne, Sylvie, Vallet-Pichard, Anaïs, Houssel-Debry, Pauline, Duvoux, Christophe, Botta-Fridlund, Danielle, de Ledinghen, Victor, Conti, Filomena, Anty, Rodolphe, Di Martino, Vincent, Debette-Gratien, Marilyne, Leroy, Vincent, Gerster, Theophile, Lebray, Pascal, Alric, Laurent, Abergel, Armand, Dumortier, Jérôme, Besch, Camille, Montialoux, Helene, Samuel, Didier, Duclos-Vallée, Jean-Charles, Coilly, Audrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865729/
https://www.ncbi.nlm.nih.gov/pubmed/36680177
http://dx.doi.org/10.3390/v15010137
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author Meunier, Lucy
Belkacemi, Mohamed
Pageaux, George Philippe
Radenne, Sylvie
Vallet-Pichard, Anaïs
Houssel-Debry, Pauline
Duvoux, Christophe
Botta-Fridlund, Danielle
de Ledinghen, Victor
Conti, Filomena
Anty, Rodolphe
Di Martino, Vincent
Debette-Gratien, Marilyne
Leroy, Vincent
Gerster, Theophile
Lebray, Pascal
Alric, Laurent
Abergel, Armand
Dumortier, Jérôme
Besch, Camille
Montialoux, Helene
Samuel, Didier
Duclos-Vallée, Jean-Charles
Coilly, Audrey
author_facet Meunier, Lucy
Belkacemi, Mohamed
Pageaux, George Philippe
Radenne, Sylvie
Vallet-Pichard, Anaïs
Houssel-Debry, Pauline
Duvoux, Christophe
Botta-Fridlund, Danielle
de Ledinghen, Victor
Conti, Filomena
Anty, Rodolphe
Di Martino, Vincent
Debette-Gratien, Marilyne
Leroy, Vincent
Gerster, Theophile
Lebray, Pascal
Alric, Laurent
Abergel, Armand
Dumortier, Jérôme
Besch, Camille
Montialoux, Helene
Samuel, Didier
Duclos-Vallée, Jean-Charles
Coilly, Audrey
author_sort Meunier, Lucy
collection PubMed
description Background: Direct-acting antiviral (DAA) agents for the treatment of hepatitis C virus (HCV) infection have been proven safe and effective in cirrhotic patients awaiting liver transplantation (LT). However, in the long term, data remain minimal regarding the clinical impact of viral eradication on patients listed for decompensated cirrhosis or hepatocellular carcinoma (HCC). We aimed to elucidate the clinical outcomes of patients regarding delisting and the evolution of HCC during the long-term follow-up. Methods: An observational, multicenter, retrospective analysis was carried out on prospectively collected data from HCV-positive patients treated with an interferon-free regimen while awaiting LT in 18 French hospitals. Results: A total of 179 patients were included in the study. The indication for LT was HCC in 104 (58.1%) patients and cirrhosis in 75 (41.9%) patients. The sustained virological response was 84.4% and the treatment was well tolerated. At five years, among 75 patients with cirrhosis treated for HCV, 19 (25.3%) were delisted following improvement after treatment. Predictive factors for delisting highlighted an absence of ascites, MELD score ≤ 15, and Child–Pugh score ≤ 7. No patients with refractory ascites were delisted. Among patients with HCC, 82 (78.9%) were transplanted. The drop-out rate was low (6.7%) and few recurrences of HCC after LT were observed. Conclusions: DAAs are safe and effective in patients awaiting LT for cirrhosis or HCC. A quarter of patients with cirrhosis can be delisted because of clinical improvement. Predictive factors for delisting, as a result of improvement, may assist prescribers, before initiating HCV infection therapy in the long-term perspective.
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spelling pubmed-98657292023-01-22 Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years? Meunier, Lucy Belkacemi, Mohamed Pageaux, George Philippe Radenne, Sylvie Vallet-Pichard, Anaïs Houssel-Debry, Pauline Duvoux, Christophe Botta-Fridlund, Danielle de Ledinghen, Victor Conti, Filomena Anty, Rodolphe Di Martino, Vincent Debette-Gratien, Marilyne Leroy, Vincent Gerster, Theophile Lebray, Pascal Alric, Laurent Abergel, Armand Dumortier, Jérôme Besch, Camille Montialoux, Helene Samuel, Didier Duclos-Vallée, Jean-Charles Coilly, Audrey Viruses Article Background: Direct-acting antiviral (DAA) agents for the treatment of hepatitis C virus (HCV) infection have been proven safe and effective in cirrhotic patients awaiting liver transplantation (LT). However, in the long term, data remain minimal regarding the clinical impact of viral eradication on patients listed for decompensated cirrhosis or hepatocellular carcinoma (HCC). We aimed to elucidate the clinical outcomes of patients regarding delisting and the evolution of HCC during the long-term follow-up. Methods: An observational, multicenter, retrospective analysis was carried out on prospectively collected data from HCV-positive patients treated with an interferon-free regimen while awaiting LT in 18 French hospitals. Results: A total of 179 patients were included in the study. The indication for LT was HCC in 104 (58.1%) patients and cirrhosis in 75 (41.9%) patients. The sustained virological response was 84.4% and the treatment was well tolerated. At five years, among 75 patients with cirrhosis treated for HCV, 19 (25.3%) were delisted following improvement after treatment. Predictive factors for delisting highlighted an absence of ascites, MELD score ≤ 15, and Child–Pugh score ≤ 7. No patients with refractory ascites were delisted. Among patients with HCC, 82 (78.9%) were transplanted. The drop-out rate was low (6.7%) and few recurrences of HCC after LT were observed. Conclusions: DAAs are safe and effective in patients awaiting LT for cirrhosis or HCC. A quarter of patients with cirrhosis can be delisted because of clinical improvement. Predictive factors for delisting, as a result of improvement, may assist prescribers, before initiating HCV infection therapy in the long-term perspective. MDPI 2022-12-31 /pmc/articles/PMC9865729/ /pubmed/36680177 http://dx.doi.org/10.3390/v15010137 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Meunier, Lucy
Belkacemi, Mohamed
Pageaux, George Philippe
Radenne, Sylvie
Vallet-Pichard, Anaïs
Houssel-Debry, Pauline
Duvoux, Christophe
Botta-Fridlund, Danielle
de Ledinghen, Victor
Conti, Filomena
Anty, Rodolphe
Di Martino, Vincent
Debette-Gratien, Marilyne
Leroy, Vincent
Gerster, Theophile
Lebray, Pascal
Alric, Laurent
Abergel, Armand
Dumortier, Jérôme
Besch, Camille
Montialoux, Helene
Samuel, Didier
Duclos-Vallée, Jean-Charles
Coilly, Audrey
Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title_full Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title_fullStr Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title_full_unstemmed Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title_short Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?
title_sort patients treated for hcv infection and listed for liver transplantation in a french multicenter study: what happens at five years?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865729/
https://www.ncbi.nlm.nih.gov/pubmed/36680177
http://dx.doi.org/10.3390/v15010137
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