Volume 8 Issue 1
Jan.  2017
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Niu Ying, Ming Yingzi, She Xingguo, et al. Preliminary observation of clinical efficacy and safety of direct-acting antiviral agents for hepatitis C virus following renal transplantation[J]. ORGAN TRANSPLANTATION, 2017, 8(1): 49-53. doi: 10.3969/j.issn.1674-7445.2017.01.010
Citation: Niu Ying, Ming Yingzi, She Xingguo, et al. Preliminary observation of clinical efficacy and safety of direct-acting antiviral agents for hepatitis C virus following renal transplantation[J]. ORGAN TRANSPLANTATION, 2017, 8(1): 49-53. doi: 10.3969/j.issn.1674-7445.2017.01.010
shu

Preliminary observation of clinical efficacy and safety of direct-acting antiviral agents for hepatitis C virus following renal transplantation

doi: 10.3969/j.issn.1674-7445.2017.01.010

  • Department of Organ Transplantation, the 3rd Xiangya Hospital of Central South University, Changsha 410013, China

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  • Corresponding author: Niu Ying, E-mail:niuying1@aliyun.com
  • Received Date: 2016-10-12
    Available Online: 2021-01-19
  • Publish Date: 2017-01-15
    Abstract
  •   Objective  To observe the clinical efficacy and safety of direct-acting antiviral agents (DAAs) in the treatment of hepatitis C after renal transplantation.  Methods  Six patients were complicated with hepatitis C virus (HCV) at 8 to 43 months after renal transplantation with a median time of 19 months. Prior to treatment, the virus load was detected from 4.03×103 to 8.18×107 IU/mL. Four cases were administered with tacrolimus (FK506) + mycophenolate mofetil (MMF) + prednisone (Pred), and the remaining 2 received cyclosporin (CsA) + MMF + Pred. The serum creatinine level was lower than 200 μmol/L. The amount of urine and body weight remained stable. No severe mental irritation or trauma history was reported within 6 months before antiviral therapy. Six patients did not receive genotype test of HCV before DAAs therapy. Four patients were administered with sofosbuvir, 1 with sofosbuvir + ledipavir and 1 with sofosbuvir + daclatasvir for 12 weeks. The complete blood cell count, serum transaminase level, creatinine level and blood concentration of immunosuppressive agents were measured each week and serum HCV RNA level was quantitatively detected every 4 weeks.  Results  Among 6 patients, 5 were negative for HCV at 4 weeks after DAAs therapy and obtained sustained virological response (SVR) after DAAs treatment. One case administered with sofosbuvir alone was positive for HCV after DAAs therapy. The patient was infected with genotype 5 HCV. After 12-week administration of sofosbuvir + daclatasvir, the patient was negative for HCV and obtained SVR. No significant changes were observed in complete blood cell count, serum transaminase level, creatinine level and blood concentration of immunosuppressive agents. Adverse reactions included evanescent eruption in 1 case and mild dizziness in 1 case.  Conclusions  DAAs treatment is an effective and safe approach for patients with stable renal function after renal transplantation. Combined use of sofosbuvir+ daclatasvir is recommended as the optimal therapy.

     

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