In HCV, Interferon-Free Antiviral Best After Liver Transplant
Patients who receive an interferon-free antiviral regimen for Hepatitis C virus (HCV) after a liver transplant have a low rate of adverse complications and an increased rate of sustained virologic response, according to a recent study.
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“Hepatitis C virus (HCV) infection is the leading indication for liver transplantation worldwide, and interferon-containing regimens are associated with low response rates owing to treatment-limiting toxic effects in immunosuppressed liver-transplant recipients,” said the authors of the study.
“We evaluated the interferon-free regimen of the NS5A inhibitor ombitasvir coformulated with the ritonavir-boosted protease inhibitor ABT-450 (ABT-450/r), the nonnucleoside NS5B polymerase inhibitor dasabuvir, and ribavirin in liver-transplant recipients with recurrent HCV genotype 1 infection,” they said.
For the study, researchers monitored 34-liver transplant patients who had either mild fibrosis or no history of fibrosis. The participants were administered ombitasvir–ABT-450/r (at a dose of 25 mg of ombitasvir, 100 mg of ritonavir, and 150 mg of ABT-450 once per day), dasabuvir (250 mg twice a day), and ribavirin for a 24-week duration.
According to researchers, they were looking for a sustained, virologic response around 12 weeks after the end of patients’ treatment.
The study showed that 33 of the patients achieved a rate of 97% sustained virologic response at 12 and 24 weeks post-treatment. Further, 15% of patients needed erythroprotein and none of the patients required a blood transfusion.
Investigators noted that the most prevalent, adverse complications were headache, cough, and fatigue.
The complete study is published in the December issue of the New England Journal of Medicine.
-Michelle Canales
Reference:
Kwo PY, Mantry PS, Coakley E, et al. An interferon-free antiviral regimen for HCV after liver transplantation. N Engl J Med. 2014 December [epub ahead of print] doi: 10.1056/NEJMoa1408921.