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

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

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbere13109
JournalClinical Transplantation
Volume31
Issue number11
DOIs
Publication statusPublished - 2017 Nov

Keywords

  • asunaprevir
  • daclatasvir
  • hepatitis C
  • liver transplantation

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Ikegami, T., Ueda, Y., Akamatsu, N., Ishiyama, K., Goto, R., Soyama, A., Kuramitsu, K., Honda, M., Shinoda, M., Yoshizumi, T., Okajima, H., Kitagawa, Y., Inomata, Y., Ku, Y., Eguchi, S., Taketomi, A., Ohdan, H., Kokudo, N., Shimada, M., ... Maehara, Y. (2017). Asunaprevir and daclatasvir for recurrent hepatitis C after liver transplantation: A Japanese multicenter experience. Clinical Transplantation, 31(11), [e13109]. https://doi.org/10.1111/ctr.13109