TY - JOUR
T1 - Asunaprevir and daclatasvir for recurrent hepatitis C after liver transplantation
T2 - A Japanese multicenter experience
AU - Ikegami, Toru
AU - Ueda, Yoshihide
AU - Akamatsu, Nobuhisa
AU - Ishiyama, Kohei
AU - Goto, Ryoichi
AU - Soyama, Akihiko
AU - Kuramitsu, Kaori
AU - Honda, Masaki
AU - Shinoda, Masahiro
AU - Yoshizumi, Tomoharu
AU - Okajima, Hideaki
AU - Kitagawa, Yuko
AU - Inomata, Yukihiro
AU - Ku, Yonson
AU - Eguchi, Susumu
AU - Taketomi, Akinobu
AU - Ohdan, Hideki
AU - Kokudo, Norihiro
AU - Shimada, Mitsuo
AU - Yanaga, Katsuhiko
AU - Furukawa, Hiroyuki
AU - Uemoto, Shinji
AU - Maehara, Yoshihiko
N1 - Funding Information:
This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare, Japan (17fk0210107 h0001).
Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2017/11
Y1 - 2017/11
N2 - The safety and efficacy of an IFN-free regimen using asunaprevir (ASV) and daclatasvir (DCV) for recurrent hepatitis C virus (HCV) infection after liver transplantation (LT) have not been evaluated in Japan. A multicenter study of LT recipients (n = 74) with recurrent HCV genotype 1b infection treated with ASV-DCV for 24 weeks was performed. Medical history was positive for pegylated interferon and ribavirin (Peg-IFN/RBV) in 40 (54.1%) patients, and for simeprevir (SMV) with Peg-IFN/RBV in 12 (16.2%) patients. Resistance-associated variants (RAVs) were positive at D168 (n = 1) in the NS3, and at L31 (n = 4), Y93 (n = 4), and L31/Y93 (n = 1) in the NS5A region of the HCV genome. Sixty-one (82.4%) patients completed the 24-week treatment protocol. Although sustained viral response (SVR) was achieved in 49 (80.3%) patients, it was achieved in only two (16.7%) patients among those with histories of receiving SMV (n = 12). Univariate analysis showed that a history of SMV (P <.01) and the presence of mutations in NS5A (P =.02) were the significant factors for no-SVR. By excluding the patients with either a history of SMV-based treatment or RAVs in NS3/NS5A, the SVR rate was 96.4%. By excluding the patients with a history of SMV and those with RAVs in NS3/NS5A, viral clearance of ASV-DCV was favorable, with a high SVR rate.
AB - The safety and efficacy of an IFN-free regimen using asunaprevir (ASV) and daclatasvir (DCV) for recurrent hepatitis C virus (HCV) infection after liver transplantation (LT) have not been evaluated in Japan. A multicenter study of LT recipients (n = 74) with recurrent HCV genotype 1b infection treated with ASV-DCV for 24 weeks was performed. Medical history was positive for pegylated interferon and ribavirin (Peg-IFN/RBV) in 40 (54.1%) patients, and for simeprevir (SMV) with Peg-IFN/RBV in 12 (16.2%) patients. Resistance-associated variants (RAVs) were positive at D168 (n = 1) in the NS3, and at L31 (n = 4), Y93 (n = 4), and L31/Y93 (n = 1) in the NS5A region of the HCV genome. Sixty-one (82.4%) patients completed the 24-week treatment protocol. Although sustained viral response (SVR) was achieved in 49 (80.3%) patients, it was achieved in only two (16.7%) patients among those with histories of receiving SMV (n = 12). Univariate analysis showed that a history of SMV (P <.01) and the presence of mutations in NS5A (P =.02) were the significant factors for no-SVR. By excluding the patients with either a history of SMV-based treatment or RAVs in NS3/NS5A, the SVR rate was 96.4%. By excluding the patients with a history of SMV and those with RAVs in NS3/NS5A, viral clearance of ASV-DCV was favorable, with a high SVR rate.
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U2 - 10.1111/ctr.13109
DO - 10.1111/ctr.13109
M3 - Article
C2 - 28881052
AN - SCOPUS:85030242819
VL - 31
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 11
M1 - e13109
ER -
