Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study.

Manzardo, C ; Londoño, MC ; Castells, L ; Testillano, M ; Montero, JL ; Peñafiel, J ; Subirana, M ; Moreno, A ; Aguilera, V ; González-Diéguez, ML ; Calvo-Pulido, J ; Xiol, X ; Salcedo, M ; Cuervas-Mons, V ; Sousa, JM ; Suarez, F ; Serrano, T (Universidad de Zaragoza) ; Herrero, JI ; Jiménez, M ; Fernandez, JR ; Giménez, C ; del Campo, S ; Esteban-Mur, JI ; Crespo, G ; Moreno, A ; de la Rosa, G ; Rimola, A ; Miro, JM

Resumen: Direct-acting antivirals have proved to be highly efficacious and safe in monoinfected liver transplant (LT) recipients who experience recurrence of hepatitis C virus (HCV) infection. However, there is a lack of data on effectiveness and tolerability of these regimens in HCV/HIV-coinfected patients who experience recurrence of HCV infection after LT. In this prospective, multicenter cohort study, the outcomes of 47 HCV/HIV-coinfected LT patients who received DAA therapy (with or without ribavirin [RBV]) were compared with those of a matched cohort of 148 HCV-monoinfected LT recipients who received similar treatment. Baseline characteristics were similar in both groups. HCV/HIV-coinfected patients had a median (IQR) CD4 T-cell count of 366 (256-467) cells/µL. HIV-RNA was <50 copies/mL in 96% of patients. The DAA regimens administered were SOF + LDV ± RBV (34%), SOF + SMV ± RBV (31%), SOF + DCV ± RBV (27%), SMV + DCV ± RBV (5%), and 3D (3%), with no differences between the groups. Treatment was well tolerated in both groups. Rates of SVR (negative serum HCV-RNA at 12 weeks after the end of treatment) were high and similar for coinfected and monoinfected patients (95% and 94%, respectively; P = .239). Albeit not significant, a trend toward lower SVR rates among patients with advanced fibrosis (P = .093) and genotype 4 (P = .088) was observed. In conclusion, interferon-free regimens with DAAs for post-LT recurrence of HCV infection in HIV-infected individuals were highly effective and well tolerated, with results comparable to those of HCV-monoinfected patients.

Idioma: Inglés

DOI: 10.1111/ajt.14996

Año: 2018

Publicado en: AMERICAN JOURNAL OF TRANSPLANTATION 18, 10 (2018), 2513-2522
ISSN: 1600-6135

Factor impacto JCR: 7.163 (2018)

Categ. JCR: TRANSPLANTATION rank: 2 / 25 = 0.08 (2018) - Q1 - T1
Categ. JCR: SURGERY rank: 5 / 203 = 0.025 (2018) - Q1 - T1

Factor impacto SCIMAGO: 3.2 - Immunology and Allergy (Q1) - Transplantation (Q1) - Pharmacology (medical) (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)