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

Christian Manzardo, Maria C. Londoño, LLuís Castells, Milagros Testillano, José Luis Montero, Judit Peñafiel, Marta Subirana, Ana Moreno, Victoria Aguilera, María Luisa González-Diéguez, Jorge Calvo-Pulido, Xavier Xiol, Magdalena Salcedo, Valentin Cuervas-Mons, José Manuel Sousa, Francisco Suarez, Trinidad Serrano, Jose Ignacio Herrero, Miguel Jiménez, José R. FernandezCarlos Giménez, Santos del Campo, Juan I. Esteban-Mur, Gonzalo Crespo, Asunción Moreno, Gloria de la Rosa, Antoni Rimola, Jose M. Miro, F. Suárez, M. A. Castro, S. López, J. D. Pedreira, P. Vázquez, F. Agüero, J. Blanch, M. Brunet, D. Calatayud, C. Cervera, E. de Lazzari, C. Fondevila, A. Forner, J. Fuster, X. Forns, A. Gil, J. M. Gatell, M. Laguno, A. Lligoña, J. Mallolas, J. Murillas, M. Navasa, D. Paredes, I. Pérez, F. Torres, C. Tural, M. Tuset, A. Antela, E. Losada, E. Molina, E. Otero, E. Varo, J. J. Araiz, E. Barrao, J. Larraga, S. Letona, R. Lozano, P. Luque, A. Navarro, I. Sanjoaquín, E. Tejero, R. Bañares, J. Berenguer, G. Clemente, J. Cosín, J. P. Ferreiroa, J. L. García-Sabrido, I. Gutiérrez, J. C. López, P. Miralles, M. Ramírez, D. Rincón, M. Sánchez, J. de la Cruz, J. L. Fernández, J. M. Lozano, J. Santoyo, J. M. Rodrigo, M. A. Suárez, M. Rodríguez, M. P. Alonso, V. Asensi, I. González-Pinto, A. Rafecas, C. Baliellas, J. Carratalá, J. Fabregat, N. Fernández, R. Jorba, L. Lladó, M. Montejo, J. Bustamante

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14 Citations (Scopus)

Abstract

© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons 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.
Original languageEnglish
Pages (from-to)2513-2522
JournalAmerican Journal of Transplantation
Volume18
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • clinical research/practice
  • infection and infectious agents—viral: hepatitis C
  • infection and infectious agents—viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
  • liver transplantation/hepatology

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