Durable control of hepatitis C through interferon-free antiviral combination therapy immediately prior to allogeneic haematopoietic stem cell transplantation

J Viral Hepat. 2019 Apr;26(4):454-458. doi: 10.1111/jvh.13046. Epub 2018 Dec 28.

Abstract

Chronic hepatitis C virus (HCV) infection carries increased risks for morbidity and mortality in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) but has become curable through the advent of directly acting antiviral compounds. Current guidelines of the American Society for Blood and Marrow Transplantation (ASBMT) recommend that HCV-infected HSCT candidates preferably start and complete therapy prior to transplant. However, this is often not feasible due to time constraints or treatment-limiting comorbidities, conditions and treatments. For these reasons, data on the safety of antiviral treatment, its efficacy to achieve durable eradication of the virus until full immune recovery, and late effects of former HCV infection in patients receiving HSCT are unknown. Here, we report the course of two paediatric patients with chronic HCV infection who received a full course of directly acting antivirals prior to allogeneic HSCT and achieved and maintained viral eradication throughout transplantation until complete immune recovery.

Keywords: Hepatitis C; acute leukaemia; bone marrow failure; children; transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Child
  • Drug Therapy, Combination
  • Hematopoietic Stem Cell Transplantation*
  • Hepacivirus / drug effects
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / surgery*
  • Humans
  • Male
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Antiviral Agents