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Ledipasvir/sofosbuvir without ribavirin is effective in the treatment of recurrent hepatitis C virus infection post-liver transplant

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Abstract

Background/aim

Recurrent hepatitis C virus infection is a challenging complication post-liver transplant. Current guidelines recommend the combination of ribavirin and ledipasvir/sofosbuvir for 12 weeks for the treatment of recurrent HCV genotype 1 post-liver transplant. Data are limited on the use of ledipasvir/sofosbuvir without ribavirin. The aim of this study was to evaluate the use of ledipasvir/sofosbuvir without ribavirin for the treatment of recurrent hepatitis C virus post-liver transplant.

Methods

This is a retrospective study of liver transplant patients who received ledipasvir/sofosbuvir without ribavirin for the treatment of recurrent hepatitis C virus in our liver center from 2014 to 2016.

Results

A total of 60 patients were enrolled of which 70% were male, 88% Caucasian, age 60 ± 7 years, 15% cirrhotic, and 45% treatment-experienced with recurrent hepatitis C virus infection genotype 1 post-liver transplant. Treatment duration varied from 8 to 24 weeks. There were no serious adverse events and no discontinuation of treatment. A total of 71% of patients had undetectable serum hepatitis C virus at 4 weeks. However, irrespective of treatment duration, 100% of patients had undetectable serum hepatitis C virus at the end of treatment and 100% of patients achieved sustained viral response at 12 weeks.

Conclusion

Ledipasvir/sofosbuvir without ribavirin is an effective treatment of recurrent hepatitis C virus infection post-liver transplant. The entire group achieved sustained viral response at 12 weeks irrespective of the length of treatment. The combination of ledipasvir/sofosbuvir was well tolerated without serious adverse effects or discontinuation.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 1808 7th Ave South, BDB 391, Birmingham, AL, 5294, USA

    Mohamed Shoreibah & Omar Massoud

  2. Department of Internal Medicine, Tinsley Harrison Internal Medicine Residency Program, University of Alabama at Birmingham, 1720 2nd Ave South, BDB 327, Birmingham, AL, 35294, USA

    Jordan Orr

  3. The University of Alabama at Birmingham, 1802 6th Ave South, Birmingham, 35233, AL, USA

    DeAnn Jones & Jie Zhang

  4. Department of Medicine, Montgomery Internal Medicine Residency Program, University of Alabama at Birmingham, 2055 E. South Blvd., Suite 200, Montgomery, 36116, AL, USA

    Krishna Venkata

Authors
  1. Mohamed Shoreibah
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  2. Jordan Orr
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  3. DeAnn Jones
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  4. Jie Zhang
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  5. Krishna Venkata
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  6. Omar Massoud
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Corresponding author

Correspondence to Jordan Orr.

Ethics declarations

Compliance with ethical standards

All authors are in compliance with ethical standards for this study.

Funding

This study has no funding sources, grants, or other types of financial support to disclose.

Conflict of interest

Mohamed Shoreibah was a participant on the Gilead advisory board on 5/29/2015 and Omar Massoud received research grants and education grants from Gilead. Jordan Orr, DeAnn Jones, Jie Zhang, and Krishna Venkata have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was not required for this study as decided by our university’s institutional review board (IRB).

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Shoreibah, M., Orr, J., Jones, D. et al. Ledipasvir/sofosbuvir without ribavirin is effective in the treatment of recurrent hepatitis C virus infection post-liver transplant. Hepatol Int 11, 434–439 (2017). https://doi.org/10.1007/s12072-016-9778-6

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  • DOI: https://doi.org/10.1007/s12072-016-9778-6

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