Three patients treated with sofosbuvir plus ledipasvir for recurrent hepatitis C after liver transplantation
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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.
KeywordsChronic hepatitis C Liver transplantation Sofosbuvir plus ledipasvir Immunosuppressive agents Resistance-associated variant
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.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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