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Clinical Journal of Gastroenterology

, Volume 10, Issue 2, pp 179–184 | Cite as

Three patients treated with sofosbuvir plus ledipasvir for recurrent hepatitis C after liver transplantation

  • Tomokazu Kawaoka
  • Michio ImamuraEmail author
  • Kei Morio
  • Yuki Nakamura
  • Masataka Tsuge
  • Clair Nelson Hayes
  • Yoshiiku Kawakami
  • Hiroshi Aikata
  • Hidenori Ochi
  • Kouhei Ishiyama
  • Hideki Ohdan
  • Kazuaki Chayama
Case Report

Abstract

We previously reported results of interferon (IFN)-free daclatasvir and asunaprevir for the treatment of recurrent hepatitis C virus (HCV) genotype 1 infection after liver transplantation (LT). Here we report three patients who achieved viral response with no effect on the blood concentrations of immunosuppressive agents following sofosbuvir plus ledipasvir treatment. The first patient was a 68-year-old female with HCV-related liver cirrhosis who failed to respond to pegylated-IFN and ribavirin (PEG-IFN/RBV) after living donor LT. She had been treated with 50 mg/day of cyclosporine. The second was a 63-year-old male with HCV-related liver cirrhosis and hepatocellular carcinoma who failed to respond to PEG-IFN/RBV after living donor LT. He had been treated with 50 mg/day of cyclosporine. The third was a 63-year-old female with HCV-related liver cirrhosis. She had been treated with tacrolimus. High alanine aminotransferase levels persisted after LT. Liver biopsy examination revealed active hepatitis or chronic rejection. Therefore, sofosbuvir plus ledipasvir therapy was started. However, the combination treatment was stopped at 4 weeks due to development of interstitial pneumonia. Serum HCV RNA became negative at the time treatment was discontinued and remained negative 12 weeks after cessation of therapy in all three cases. Sofosbuvir plus ledipasvir treatment showed a remarkable viral response with little effect on blood levels of immunosuppressive agents for recurrent HCV genotype 1 infection after LT.

Keywords

Chronic hepatitis C Liver transplantation Sofosbuvir plus ledipasvir Immunosuppressive agents Resistance-associated variant 

Notes

Compliance with ethical standards

Conflict of interest

Kazuaki Chayama received honoraria from MSD K.K.,Bristol-Meyers Squibb and research funding from Abbvie, Dainippon Sumitomo Pharma, The Institute of Physical and Chemical Research (RIKEN). Michio Imamura received research funding from Bristol-Meyers Squibb. Masataka Tsuge received research funding from Bristol-Meyers Squibb. The other authors declare no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

None.

Supplementary material

12328_2017_722_MOESM1_ESM.pdf (53 kb)
Supplementary material 1 (PDF 52 kb)
12328_2017_722_MOESM2_ESM.pdf (47 kb)
Supplementary material 2 (PDF 46 kb)

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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  • Tomokazu Kawaoka
    • 1
  • Michio Imamura
    • 1
    Email author
  • Kei Morio
    • 1
  • Yuki Nakamura
    • 1
  • Masataka Tsuge
    • 1
  • Clair Nelson Hayes
    • 1
  • Yoshiiku Kawakami
    • 1
  • Hiroshi Aikata
    • 1
  • Hidenori Ochi
    • 2
  • Kouhei Ishiyama
    • 3
  • Hideki Ohdan
    • 3
  • Kazuaki Chayama
    • 1
    • 2
  1. 1.Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
  2. 2.Laboratory for Digestive Diseases, Center for Genomic MedicineRIKENHiroshimaJapan
  3. 3.Programs for Biomedical Research, Division of Frontier Medical Science, Department of Surgery, Graduate School of Biomedical ScienceHiroshima UniversityHiroshimaJapan

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