Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study

Background: Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated...

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Autores: González-Corvillo, Carmen, Crespo Barrio, Marta, Gentil, Miguel Ángel
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2019
País:España
Recursos:Universitat Pompeu Fabra
Repositório:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/47248
Acesso em linha:http://hdl.handle.net/10230/47248
http://dx.doi.org/10.1097/TXD.0000000000000954
Access Level:Acceso aberto
Palavra-chave:Ronyons--Trasplantació
Medicaments antivírics
Hepatitis C -- Espanya
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spelling Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational studyGonzález-Corvillo, CarmenCrespo Barrio, MartaGentil, Miguel ÁngelRonyons--TrasplantacióMedicaments antivíricsHepatitis C -- EspanyaBackground: Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. Methods: Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. Results: Patients (N = 226) were mostly male (65.9%) aged 56.1 ± 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 ± 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 ± 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4-41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. Conclusions: Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function.Wolters Kluwer (LWW)202120212019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/47248http://dx.doi.org/10.1097/TXD.0000000000000954reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésCopyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), http://creativecommons.org/licenses/by-nc-nd/4.0/. where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/472482026-06-12T07:21:37Z
dc.title.none.fl_str_mv Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
title Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
spellingShingle Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
González-Corvillo, Carmen
Ronyons--Trasplantació
Medicaments antivírics
Hepatitis C -- Espanya
title_short Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
title_full Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
title_fullStr Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
title_full_unstemmed Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
title_sort Direct-acting antivirals for the treatment of kidney transplant patients with chronic hepatitis C virus infection in Spain: a long-term prospective observational study
dc.creator.none.fl_str_mv González-Corvillo, Carmen
Crespo Barrio, Marta
Gentil, Miguel Ángel
author González-Corvillo, Carmen
author_facet González-Corvillo, Carmen
Crespo Barrio, Marta
Gentil, Miguel Ángel
author_role author
author2 Crespo Barrio, Marta
Gentil, Miguel Ángel
author2_role author
author
dc.subject.none.fl_str_mv Ronyons--Trasplantació
Medicaments antivírics
Hepatitis C -- Espanya
topic Ronyons--Trasplantació
Medicaments antivírics
Hepatitis C -- Espanya
description Background: Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. Methods: Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. Results: Patients (N = 226) were mostly male (65.9%) aged 56.1 ± 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 ± 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 ± 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4-41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. Conclusions: Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function.
publishDate 2019
dc.date.none.fl_str_mv 2019
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/47248
http://dx.doi.org/10.1097/TXD.0000000000000954
url http://hdl.handle.net/10230/47248
http://dx.doi.org/10.1097/TXD.0000000000000954
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wolters Kluwer (LWW)
publisher.none.fl_str_mv Wolters Kluwer (LWW)
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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