Asunaprevir and daclatasvir for recurrent hepatitis C after liver transplantation: A Japanese multicenter experience

作者：Ikegami Toru^*; Ueda Yoshihide; Akamatsu Nobuhisa; Ishiyama Kohei; Goto Ryoichi; Soyama Akihiko; Kuramitsu Kaori; Honda Masaki; Shinoda Masahiro; Yoshizumi Tomoharu; Okajima Hideaki; Kitagawa Yuko; Inomata Yukihiro; Ku Yonson; Eguchi Susumu; Taketomi Akinobu; Ohdan Hideki; Kokudo Norihiro; Shimada Mitsuo; Yanaga Katsuhiko; Furukawa Hiroyuki; Uemoto Shinji; Maehara Yoshihiko

来源：Clinical Transplantation, 2017, 31(11): e13109.

DOI：10.1111/ctr.13109

• asunaprevir
• daclatasvir
• hepatitis C
• liver transplantation

The safety and efficacy of an IFN-free regimen using asunaprevir (ASV) and daclatasvir (DCV) for recurrent hepatitis C virus (HCV) infection after liver transplantation (LT) have not been evaluated in Japan. A multicenter study of LT recipients (n = 74) with recurrent HCV genotype 1b infection treated with ASV-DCV for 24 weeks was performed. Medical history was positive for pegylated interferon and ribavirin (Peg-IFN/RBV) in 40 (54.1%) patients, and for simeprevir (SMV) with Peg-IFN/RBV in 12 (16.2%) patients. Resistance-associated variants (RAVs) were positive at D168 (n = 1) in the NS3, and at L31 (n = 4), Y93 (n = 4), and L31/Y93 (n = 1) in the NS5A region of the HCV genome. Sixty-one (82.4%) patients completed the 24-week treatment protocol. Although sustained viral response (SVR) was achieved in 49 (80.3%) patients, it was achieved in only two (16.7%) patients among those with histories of receiving SMV (n = 12). Univariate analysis showed that a history of SMV (P < .01) and the presence of mutations in NS5A (P = .02) were the significant factors for no-SVR. By excluding the patients with either a history of SMV-based treatment or RAVs in NS3/NS5A, the SVR rate was 96.4%. By excluding the patients with a history of SMV and those with RAVs in NS3/NS5A, viral clearance of ASV-DCV was favorable, with a high SVR rate.

• 出版日期2017-11