Background & Aims: Hepatitis C virus (HCV) re-infection following liver transplant (LT) is associated with reduced graft and patient survival. Before transplant, Sofosbuvir/ Ribavirin (SOF/R) treatment prevents recurrent HCV in 96% of those patients achieving viral suppression for at least 4 weeks before transplant. We evaluated whether a bridging SOF-regimen from pre- to post-transplant is safe and effective to prevent HCV recurrence in those patients with less than 4 weeks of HCV-RNA undetectability at the time of transplant. Methods: From July 2014 SOF/R was given in 233 waitlisted HCV cirrhotics with/ without hepatocellular carcinoma (HCC) within an Italian Compassionate Program. One hundred patients were transplanted and 31 patients (31%) treated with SOF/R bridging therapy were studied. Results: Liver transplant indication in bridge subgroup was HCC in 22 and decompensated cirrhosis in 9. HCV-genotype was 1/4 in 18 patients. SOF 400 mg/day and R (median dosage 800 mg/day) were given for a median of 35 days before LT. At transplant time, 19 patients were still HCV-RNA positive (median HCV-RNA 58 IU/mL). One recipient had a virological breakthrough at week 4 post-transplant; one died, on treatment, 1-month post-transplant for sepsis and 29/31 achieved a 12-week sustained virological response (94%). Acute cellular rejection occurred in three recipients. On September 2016, 30 recipients (97%) were alive with a median follow-up of 18 months (range 13-25). Conclusions: In patients with suboptimal virological response at LT, a bridging SOF/R regimen helps avoiding post-transplant graft reinfection.

Donato, M., Morelli, C., Romagnoli, R., Invernizzi, F., Mazzarelli, C., Iemmolo, R., et al. (2017). Prevention of hepatitis C recurrence by bridging sofosbuvir/ribavirin from pre- to post-liver transplant: A real-life strategy. LIVER INTERNATIONAL, 37(5), 678-683 [10.1111/liv.13322].

Prevention of hepatitis C recurrence by bridging sofosbuvir/ribavirin from pre- to post-liver transplant: A real-life strategy

Malinverno, Federica;De Carlis, Luciano
Membro del Collaboration Group
;
2017

Abstract

Background & Aims: Hepatitis C virus (HCV) re-infection following liver transplant (LT) is associated with reduced graft and patient survival. Before transplant, Sofosbuvir/ Ribavirin (SOF/R) treatment prevents recurrent HCV in 96% of those patients achieving viral suppression for at least 4 weeks before transplant. We evaluated whether a bridging SOF-regimen from pre- to post-transplant is safe and effective to prevent HCV recurrence in those patients with less than 4 weeks of HCV-RNA undetectability at the time of transplant. Methods: From July 2014 SOF/R was given in 233 waitlisted HCV cirrhotics with/ without hepatocellular carcinoma (HCC) within an Italian Compassionate Program. One hundred patients were transplanted and 31 patients (31%) treated with SOF/R bridging therapy were studied. Results: Liver transplant indication in bridge subgroup was HCC in 22 and decompensated cirrhosis in 9. HCV-genotype was 1/4 in 18 patients. SOF 400 mg/day and R (median dosage 800 mg/day) were given for a median of 35 days before LT. At transplant time, 19 patients were still HCV-RNA positive (median HCV-RNA 58 IU/mL). One recipient had a virological breakthrough at week 4 post-transplant; one died, on treatment, 1-month post-transplant for sepsis and 29/31 achieved a 12-week sustained virological response (94%). Acute cellular rejection occurred in three recipients. On September 2016, 30 recipients (97%) were alive with a median follow-up of 18 months (range 13-25). Conclusions: In patients with suboptimal virological response at LT, a bridging SOF/R regimen helps avoiding post-transplant graft reinfection.
Articolo in rivista - Articolo scientifico
Hepatitis C; Hepatocellular carcinoma; Liver transplant; Sofosbuvir therapy; Virological response; Adult; Aged; Antiviral Agents; Carcinoma, Hepatocellular; Drug Therapy, Combination; Female; Hepacivirus; Hepatitis C; Humans; Italy; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Postoperative Period; Preoperative Period; Recurrence; Retrospective Studies; Ribavirin; Sofosbuvir; Sustained Virologic Response; Liver Transplantation; Hepatology
English
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683
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Donato, M., Morelli, C., Romagnoli, R., Invernizzi, F., Mazzarelli, C., Iemmolo, R., et al. (2017). Prevention of hepatitis C recurrence by bridging sofosbuvir/ribavirin from pre- to post-liver transplant: A real-life strategy. LIVER INTERNATIONAL, 37(5), 678-683 [10.1111/liv.13322].
Donato, M; Morelli, C; Romagnoli, R; Invernizzi, F; Mazzarelli, C; Iemmolo, R; Montalbano, M; Lenci, I; Bhoori, S; Pieri, G; Berardi, S; Caraceni, P; Martini, S; Angeli, P; Belli, L; Berardi, S; Bernabucci, V; Malinverno, F; Monico, S; Ottobrelli, A; Romano, A; Strona, S; Tamè, M; Visco-Comandini, U; Cavenago, M; De Carlis, L; Di Benedetto, F; Dondossola, D; Ettorre, G; Mazzaferro, V; Montin, U; Pinna, A; Rossi, G; Salizzoni, M; Tisone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/198032
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