Interferon-free Anti-hepatitis C Virus Treatment for Long-term Liver Transplantation Recipients with Failed Interferon Therapy

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  • HOSODA Kiyotaka
    First Department of Surgery, Shinshu University school of Medicine
  • MASUDA Yuichi
    First Department of Surgery, Shinshu University school of Medicine
  • MITA Atsuyoshi
    First Department of Surgery, Shinshu University school of Medicine
  • KOBAYASHI Akira
    First Department of Surgery, Shinshu University school of Medicine

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Background : Recurrent hepatitis and cirrhosis due to hepatitis C virus (HCV) infection is a major cause of graft loss in liver transplant (LT) patients. Although interferon (IFN)-based therapy has been used in patients with recurrent hepatitis C after LT, the safety and efficacy of treatment remains unclear. IFN-free regimens with direct-acting antiviral agents (DAAs) against HCV showed excellent results in terms of sustained virological response (SVR) in non-LT patients. Recently, the efficacy of DAAs for LT patients has been reported. However, drug-drug interactions, the increasing risk of hepatocellular carcinoma (HCC), and the existence of drugresistant gene variants require investigation in LT patients.<br>Method : This study included patients with recurrent hepatitis C after LT who failed IFN therapy and received IFN-free therapy. Medical records were reviewed retrospectively.<br>Results : Seven recipients were included. The median duration from LT to DAA treatment was 124 (34-181) months. HCV genotype was 1b in 6 patients and 2a in 1 patient. The Child-Pugh classification at IFN-free therapy was A in 6 patients and B in 1 patient. DAAs were used as follows : daclatasvir and asunaprevir in 3 patients, ledipasvir and sofosbuvir in 3, and sofosbuvir and ribavirin in 1. In all patients, sustained virologic response at week 24 was achieved without significant adverse events. No evidence of HCC has been observed.<br>Conclusion : HCV can be eradicated with interferon-free therapy in LT recipients with failed IFN therapy.

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