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Multicenter Study
. 2017 Aug;52(8):986-991.
doi: 10.1007/s00535-017-1310-9. Epub 2017 Jan 30.

Treatment with sofosbuvir and ledipasvir without ribavirin for 12 weeks is highly effective for recurrent hepatitis C virus genotype 1b infection after living donor liver transplantation: a Japanese multicenter experience

Yoshihide Ueda  1 , Toru Ikegami  2 , Nobuhisa Akamatsu  3 , Akihiko Soyama  4 , Masahiro Shinoda  5 , Ryoichi Goto  6 , Hideaki Okajima  7 , Tomoharu Yoshizumi  2 , Akinobu Taketomi  6 , Yuko Kitagawa  5 , Susumu Eguchi  4 , Norihiro Kokudo  3 , Shinji Uemoto  7 , Yoshihiko Maehara  2
Affiliations
Multicenter Study

Treatment with sofosbuvir and ledipasvir without ribavirin for 12 weeks is highly effective for recurrent hepatitis C virus genotype 1b infection after living donor liver transplantation: a Japanese multicenter experience

Yoshihide Ueda et al. J Gastroenterol. 2017 Aug.

Abstract

Background: The optimal therapy for recurrent hepatitis C virus (HCV) infection after liver transplantation has not yet been established. This study aimed to clarify the efficacy and safety of interferon-free therapy with sofosbuvir and ledipasvir without ribavirin for 12 weeks in Japanese patients with HCV genotype 1b infection after living donor liver transplantation.

Methods: A cohort study of living donor liver transplant recipients with recurrent HCV genotype 1b infection treated with sofosbuvir (400 mg/day) and ledipasvir (90 mg/day) was performed at six liver transplant centers in Japan.

Results: Fifty-four patients were treated with sofosbuvir and ledipasvir. Thirty-eight patients (70%) were treatment experienced, including 17 patients who had undergone prior direct-acting-antiviral-based triple therapy. Ten patients had resistance-associated substitutions at L31 or Y93 in the NS5A region of the HCV genome. Fifty-three patients completed the 12-week treatment protocol; treatment was discontinued in one patient who developed pneumonia at 4 weeks and died thereafter. All 53 patients who completed the treatment regimen achieved a sustained virological response 12 weeks after completion of treatment. Treatment was well tolerated in most patients, but seven patients developed serious adverse events, including hemorrhagic duodenal ulcers (n = 3), infection (n = 2), pleural effusion (n = 1), and alveolar hemorrhage (n = 1).

Conclusions: Sofosbuvir and ledipasvir treatment without ribavirin for 12 weeks was highly effective in achieving a sustained virological response in Japanese patients who developed recurrent HCV genotype 1b infection after living donor liver transplantation.

Keywords: Hepatitis C; Ledipasvir; Liver transplantation; Living donor; Sofosbuvir.

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