RT Journal Article
T1 Efficacy and tolerability of interferon-free antiviral therapy in kidney transplant recipients with chronic hepatitis C
A1 Fernández Vázquez, María Inmaculada
A1 Polanco, Natalia
A1 Londoño, María Carlota
AB Background & AimsThe development of direct-acting antiviral agents (DAAs) is a major step forward in the treatment of hepatitis C (HCV). The aims of the study were to evaluate the efficacy and tolerability of DAAs in kidney transplant (KT) recipients.MethodsHepa-C is a Spanish registry of patients treated with DAAs in which clinical, virological and analytical data were prospectively included. We report on the data from 103 KT recipients who received DAAs.ResultsThe most commonly used DAAs combinations were sofosbuvir/ledipasvir (n = 59, 57%) and sofosbuvir + daclatasvir (n = 18, 17%). Ribavirin was used in 41% of patients. Sustained viral response after 12 weeks (SVR12) rate was 98%. Grade 2 or 3 anemia appeared in 14 (33%) of patients receiving ribavirin and in 9 (15%) without (p = 0.03). There were three episodes of acute humoral graft rejection. No patient discontinued therapy due to adverse events. Importantly, 57 (55%) patients required immunosuppression dose adjustment. Overall, there were no statistically significant differences in the mean level of serum creatinine, eGFR and proteinuria before and after treatment. Nonetheless, seventeen (16%) patients experienced renal dysfunction (increase in serum creatinine >25%) during antiviral therapy, of whom 65% were cirrhotic in comparison with only 29% cirrhotic patients who did not develop significant renal dysfunction (p = 0.004).ConclusionsAntiviral therapy with DAAs was highly efficacious and safe in KT recipients. Nevertheless, a non-negligible number of patients, most of them cirrhotic, developed mild allograft dysfunction and a significant proportion of patients required immunosuppression dose adjustment, warranting a close follow-up during therapy.Lay summaryInfection by hepatitis C virus is often found in kidney transplant patients and its presence increases mortality and graft failure. We investigated the efficacy and safety of the new direct-acting hepatitis C antivirals in this population, in which previous information is scarce. Our data shows that, as occurs in the non-transplant setting, new anti-HCV antivirals are highly efficacious kidney transplant patients. Overall, this therapy is also quite safe, although worsening of renal function is observed in 16% of patients warranting a close follow-up observation of graft function during antiviral therapy.
PB Elsevier
SN 0168-8278
YR 2017
FD 2017-04
LK https://hdl.handle.net/20.500.14352/114155
UL https://hdl.handle.net/20.500.14352/114155
LA eng
NO Fernández I, Muñoz-Gómez R, Pascasio JM, Baliellas C, Polanco N, Esforzado N, Arias A, Prieto M, Castells L, Cuervas-Mons V, Hernández O, Crespo J, Calleja JL, Forns X, Londoño MC. Efficacy and tolerability of interferon-free antiviral therapy in kidney transplant recipients with chronic hepatitis C. J Hepatol. 2017 Apr;66(4):718-723. doi: 10.1016/j.jhep.2016.12.020
DS Docta Complutense
RD 22 abr 2025