الفهرس 
The effect of direct acting antiviral therapy on HCV recurrence post liver transplantation
ABSTRACTOnly 14 pages are availabe for public view
 |  | from | 118 |  |  |
| | | from | 118 | | |
Abstract
Background and Aim: Direct acting antivirals (DAAs) has offered treatment of HCV recurrence post liver transplantation (LT) with an all-oral regimen for short duration, excellent safety profile and high sustained virological response (SVR) rates. The aim of this study was to evaluate the efficacy and safety of Sofosbuvir (SOF) based DAA regimen in a real world setting among a cohort of patients with recurrent HCV post LT.Methods: Patients with HCV recurrence post living donor LT were recruited from National Committee of Control of Viral Hepatitis (NCCVH), Ministry of Health and Population (MOHP), Egypt from November 2014 to October 2016. They were scheduled to receive SOF based DAA therapy. Safety profile, tolerability and sustained virological response at 12 weeks after therapy completion were evaluated. Results: A total of 157 patients with recurrent HCV infection (141 males, mean age 56.1 ± 7.9 years, 37% interferon (INF) experienced, 30% advanced fibrosis; METAVIR > F2) were treated with either SOF 400 mg and ribavirin (RBV) for 24 weeks (n=119) or SOF 400 mg and simeprevir (SMV) 150 mg daily for 12 weeks (n=38). Mean duration from LT to treatment was 4.5 years. Calcineurin inhibitors were given in 141 patients. Pre-treatment biliary complications, mild acute cellular rejection (ACR) and portal vein thrombosis were present in 21.7%, 11.5% and 1.3% of patients respectively. Overall SVR12 was achieved in 87.3% (on an-intention to treat analysis);94.7% in SOF-SMV and 84.9% in SOF-RBV regimen with no significance difference (p = 0.11). History of failure of prior IFN-based therapy, higher total leucocytic count (TLC), serum albumin and prothrombin concentration (PC) and lower serum alpha fetoprotein (AFP) were significantly related to SVR12 (p < 0.05)