Treatment of chronic hepatitis C viral infection with sofosbuvir and daclatasvir in kidney transplant recipients

Transpl Infect Dis. 2019 Feb;21(1):e13018. doi: 10.1111/tid.13018. Epub 2018 Nov 22.

Abstract

Objectives: To assess the efficacy and the risk of sofosbuvir-daclatasvir treatment among kidney transplant recipients (KTRs) with chronic hepatitis C virus (HCV) infection.

Methods: A real-life retrospective cohort analysis was performed on KTRs treated with sofosbuvir-daclatasvir at our center between January 2016 and March 2018. We collected data from 19 KTRs (13 males; age 48.3 ± 9.6 years; HCV genotype I, n = 16; chronic active hepatitis B coinfection, n = 8). Virological and clinical data were assessed.

Results: Overall, 100% of the patients had achieved a sustained virological response 12 weeks after treatment (SVR12). Their liver function improved notably, with a significant decline in the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels (ALT 34.8 ± 18.6 IU/L pre-treatment and 15.0 ± 6.8 IU/L post-treatment, P = 0.0003; AST: 35.05 ± 18.1 IU/L pre-treatment and 19.1 ± 7.0 post-treatment, P = 0.001). A significant amelioration was observed in patients with proteinuria (n = 12) (0.95 [0.35-3.31] g/g at baseline to 0.39 [0.27-1.02] g/g post-therapy, P = 0.048). The serum creatinine, eGFR, and tacrolimus levels were stable during therapy.

Conclusion: The preliminary data demonstrated that sofosbuvir-daclatasvir was highly effective in treating HCV infection in KTRs with acceptable tolerance.

Keywords: daclatasvir; direct-acting antivirals; hepatitis C virus; kidney transplant; sofosbuvir.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Carbamates
  • Drug Therapy, Combination / methods
  • Female
  • Hepacivirus / drug effects
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / physiopathology
  • Hepatitis C, Chronic / virology
  • Humans
  • Imidazoles / therapeutic use*
  • Kidney Transplantation / adverse effects*
  • Liver / physiopathology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Pyrrolidines
  • Retrospective Studies
  • Sofosbuvir / therapeutic use*
  • Sustained Virologic Response
  • Transplant Recipients
  • Treatment Outcome
  • Valine / analogs & derivatives
  • Viral Load

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Pyrrolidines
  • Valine
  • daclatasvir
  • Sofosbuvir