Direct-acting Antivirals Treat Recurrent HCV After Transplant
Key clinical point: Direct-acting antivirals can help most patients with recurrent HCV after liver transplantation.
Major finding: A sustained virologic response after 4 weeks was seen in 60%-90% of patients, depending on genotype and cirrhosis.
Data source: An analysis of a multicenter database on 227 patients treated with sofosbuvir-containing regimens since December 2013 for recurrent HCV after liver transplantation.
Disclosures: The study was funded by AbbVie, Bristol Myers Squibb, Genentech, Gilead, GlaxoSmithKline, Kadmon, Janssen, Merck, and Vertex. Dr. Brown reported financial associations with AbbVie, Genentech, Gilead, Janssen, Merck, Salix, Vertex, and Vital Therapies.
AT THE LIVER MEETING 2014
Adverse events were reported by 82% of patients, with rates ranging from 77% to 92% in different treatment groups. “The majority of these were mild and manageable,” Dr. Brown noted. The overall rate of serious adverse events was 8%, ranging from 0% to 21% in different treatment groups, though some of those cases were unlikely to be related to treatment, he added.
In general, interferon-free regimens had low rates of serious adverse events, Dr. Brown said. No patients developed acute liver graft rejection.
“Hepatitis C following liver transplant does remain a problem in 2014, because reinfection is universal and therapeutic options, at least to date, have been limited,” he said. The study’s real-world data supplement encouraging results from small, controlled trials of newer anti-HCV agents in posttransplant patients.
Most of the patients in the study were treated for recurrent HCV “well after” transplantation, Dr. Brown said. “The optimal treatment regimen and the duration of therapy still remain to be determined.”
Treatment regimens in the HCV-Target study are selected by physicians according to the local standard of care.
The study was too small to do a multivariate analysis of predictive factors for SVR4, Dr. Brown commented.
The HCV-Target study was funded by AbbVie, Bristol Myers Squibb, Genentech, Gilead, GlaxoSmithKline, Kadmon, Janssen, Merck, and Vertex. Dr. Brown reported financial associations with AbbVie, Genentech, Gilead, Janssen, Merck, Salix, Vertex, and Vital Therapies.
