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DAAs show good cure rates and liver function improvement for transplant recipients with recurrent HCV
Liz Highleyman, 2014-11-27 07:40:00
Several presentations at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting this month in Boston focused on treating hepatitis C recurrence in liver transplant recipients, one of the most difficult populations to treat. Studies showed that a variety of interferon-free regimens containing the direct-acting antivirals sofosbuvir, simeprevir and daclatasvir led to high sustained virological response rates, often improved liver function, and were generally safe and reasonably well-tolerated in real-world use.
Hepatitis C virus (HCV) almost always re-infects the new donor liver after transplantation, often resulting in rapid disease progression leading to severe fibrosis or cirrhosis and potential graft loss. Liver transplant recipients have historically been difficult to treat because they do not respond as well to interferon-based therapy and often cannot tolerate its side-effects or interactions with immunosuppressant drugs used to prevent organ rejection.
New direct-acting antivirals (DAAs) that target different steps of the HCV lifecycle can now be combined in interferon-free regimens that are very well-tolerated and produce high cure rates – typically above 90% – in non-transplant patients. Clinicians are now learning how to use these drugs for liver transplant recipients and other patients who urgently need treatment in the real world.
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