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 (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Beneyto, Isabel (Hospital la Fe)
Sánchez-Fructuoso, Ana (Hospital Clínico San Carlos (Madrid))
Perelló, Manel (Hospital Universitari Vall d'Hebron)
Alonso, Angel (Complejo Hospitalario A Coruña)
Mazuecos, Auxiliadora (Hospital Universitario Puerta del Mar (Cadis, Andalusia))
Jiménez, Carlos (Hospital Universitario La Paz (Madrid))
Zárraga, Sofía (Hospital de Cruces (Barakaldo, Biscaia))
Paul, Javier (Hospital Universitario Miguel Servet (Saragossa))
Lauzurica, Ricardo (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Hernández, Domingo (Hospital Regional Universitario Carlos Haya (Málaga))
Guirado, Luis (Institut d'Investigació Biomèdica Sant Pau)
Franco, Antonio (Hospital de Alicante)
Ruiz, Juan Carlos (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Llorente, Santiago (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Crespo, Marta (Hospital del Mar (Barcelona, Catalunya))
Rodríguez-Benot, Alberto (Hospital Universitario Reina Sofía (Córdoba, Espanya))
De Gracia Guindo, María del Carmen (Hospital Universitario Virgen de las Nieves (Granada))
Díaz-Corte, Carmen (Hospital Universitario Central de Asturias)
Gentil, Miguel Ángel (Hospital Virgen Del Rocío)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	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. 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. 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. 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.
Grants:	Ministerio de Economía y Competitividad RD16/0009/0019
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Transplantation Direct, Vol. 5 Núm. 12 (2019) , p. e954, ISSN 2373-8731

DOI: 10.1097/TXD.0000000000000954
PMID: 32095505

6 p, 494.8 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles