Elimination of Hepatitis C in Liver Transplant Recipients

被引:5
|
作者
Saab, Sammy [1 ,2 ]
Challita, Youssef [1 ]
Chen, Phillip H. [2 ]
Jimenez, Melissa A. [2 ]
Lee, Alex D. [2 ]
Saab, Elena G. [2 ]
Ahn, Timothy [2 ]
Choi, Gina [1 ,2 ]
Durazo, Francisco A. [1 ,2 ]
El-Kabany, Mohamed M. [1 ,2 ]
Han, Steven-Huy B. [1 ,2 ]
Grotts, Jonathan [1 ]
Agopian, Vatche G. [2 ]
Busuttil, Ronald W. [2 ]
机构
[1] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA
[2] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA
关键词
Hepatitis C; Direct-acting agents; Liver transplant; Elimination; GENOTYPE; 1; INFECTION; VIRUS-INFECTION; UNITED-STATES; COST-EFFECTIVENESS; NONALCOHOLIC STEATOHEPATITIS; DECOMPENSATED CIRRHOSIS; ANTIVIRAL THERAPY; PLUS RIBAVIRIN; HCV INFECTION; SOFOSBUVIR;
D O I
10.14218/JCTH.2017.00079
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims: Recurrent hepatitis C (HCV) disease in liver transplant (LT) recipients is associated with significant morbidity and mortality. With the availability of noninterferonbased therapy, eliminating HCV may be achievable in LT recipients. Methods: We studied all consecutive recipients who underwent LT at the University of California Los Angeles between January 2005 and June 2017. We collected data on date of transplant and last follow-up, as well as laboratory values. We also recorded type and timing of antiviral therapy relative to LT. Analyses were performed to assess the proportion of LT recipients who are viremic after transplant. Results: Six hundred thirty-four patients underwent LT with a diagnosis of HCV. There was a statistically significant trend for patients to be cured before (p < 0.001) and after liver transplantation (p < 0.001) for the study period of 2014 to 2016 relative to 2005 and 2013, respectively. Of the 634 recipients eligible for therapy, 8% and 74% were treated within 12 months of transplant for the study periods 2005 to 2013 and 2014 to 2016, respectively. There was a significant decrease between the two study periods in the proportion of patients undergoing re-LT 1 year after the original LT: 5.5% (n = 28/510) and 1.5% (n = 2/124) respectively for study periods 2005 to 2013 and 2014 to 2016 respectively (p = 0.011). Conclusions: The proportion of LT recipients who are viremic has decreased over time. Eliminating HCV in LT recipients is feasible after the introduction of direct-acting agents. Curing HCV should translate to improved clinical outcomes in LT recipients who were transplanted for HCV infection with longer follow-up. Preliminary results suggest the decreased need for transplant in the direct-acting agents era.
引用
收藏
页码:247 / 250
页数:4
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