scholarly journals Safety and efficacy of current direct-acting antiviral regimens in kidney and liver transplant recipients with hepatitis C: Results from the HCV-TARGET study

Hepatology ◽  
2017 ◽  
Vol 66 (4) ◽  
pp. 1090-1101 ◽  
Author(s):  
Varun Saxena ◽  
Vandana Khungar ◽  
Elizabeth C. Verna ◽  
Josh Levitsky ◽  
Robert S. Brown ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Safety And Efficacy ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Liver Transplant Recipients

Therapy With Direct-Acting Antiviral Agents for Hepatitis C in Liver Transplant Recipients

2018 ◽  
Vol 50 (2) ◽  
pp. 631-633 ◽  
Author(s):  
F. Nogueras López ◽  
A. López Garrido ◽  
E.J. Ortega Suazo ◽  
F. Vadillo Calles ◽  
F. Valverde López ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Antiviral Agents ◽  
Transplant Recipients ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Liver Transplant Recipients ◽  
Direct Acting Antiviral Agents

scholarly journals Outcomes in Hepatitis C Positive Liver Transplantation: Timing of Direct-Acting Antiviral Treatment and Impact on Graft Fibrosis

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1831
Author(s):  
Jennifer Wellington ◽  
Andrew Ma ◽  
Shyam Kottilil ◽  
Bharath Ravichandran ◽  
Jennifer Husson ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Antiviral Treatment ◽  
Transplant Recipients ◽  
Direct Acting Antiviral ◽  
Related Disease ◽  
Timing Of Treatment ◽  
Direct Acting ◽  
Liver Transplant Recipients

Liver transplantation for hepatitis C virus (HCV)-related disease has the lowest five-year graft survival among all liver transplant recipients. Graft failure due to accelerated fibrosis from unrestrained HCV replication is common. Optimal timing of HCV treatment with direct-acting antiviral agents remains unknown. We compared HCV liver transplant recipients successfully treated for HCV before transplant to those treated within 1 year of transplant to determine if graft fibrosis, measured by Fib-4 scores, differs with timing of treatment. Fib-4 scores less than or equal to 1.45 defined minimal fibrosis and greater than 1.45 defined greater than minimal fibrosis. We identified 117 liver transplant recipients: 52 treated before transplantation and 65 treated within 1 year of transplantation. Overall, 34% of recipients had minimal fibrosis, and the likelihood of having minimal fibrosis following treatment and liver transplantation did not differ by timing of treatment. The odds ratio of having greater than minimal fibrosis was 0.65 (95% CI 0.30, 1.42) among those treated within 1 year after transplantation compared to those treated before transplantation (p-value 0.28). Importantly, nearly 2/3 of these patients had evidence of fibrosis progression one year after sustained virologic response, supporting recommendations for early antiviral-based treatment to prevent accumulation of HCV-related disease.

Effect of Hepatitis C Viremia on Posttransplant Diabetes Mellitus in Liver Transplant Recipients

2021 ◽  
pp. 152692482110648
Author(s):  
Kelsey Klein ◽  
Joelle Nelson ◽  
Christina Long ◽  
Kermit Speeg ◽  
Naim Alkhouri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Direct Acting Antiviral ◽  
Transplant Patients ◽  
Direct Acting ◽  
Liver Transplant Recipients ◽  
The Impact

Introduction Posttransplant diabetes mellitus (PTDM) can increase morbidity and mortality in liver transplant recipients. Although hepatitis C seropositivity is a known risk factor for PTDM, the impact of viremia versus no viremia at time of transplant is unknown. Project Aims This program evaluation sought to compare PTDM in hepatitis C seropositive patients with and without viremia at the time of liver transplant. Design This single-center retrospective review included adult hepatitis C seropositive liver transplant recipients transplanted between January 1, 2010 to September 5, 2017 without pretransplant diabetes. Primary outcome was PTDM within 1 year. Secondary outcomes included evaluating 1-year posttransplant death-censored graft loss, mortality, and metabolic outcomes. Results Fifty-seven liver transplant recipients with hepatitis C were included, of which 53% (n = 30) were viremic at transplant. Baseline characteristics were similar between groups. Significantly more patients with pretransplant viremia developed PTDM by 1-year posttransplant compared to the patients without viremia (43% vs 11%, P = 0.01). There were no differences between groups outside of more patients with viremia requiring antihypertensives by 1-year posttransplant compared to patients without viremia (57% vs 22%, P = 0.01). Conclusion Liver transplant patients with hepatitis C viremia at transplant were more likely to develop PTDM at 1 year compared to those without pretransplant viremia. This is an added consideration when deciding the timing of direct-acting antiviral (DAA) utilization in the context of liver transplant for hepatitis C seropositive patients.

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