Author | Pinto, Laura | |
Author | Balbi, Elizabeth | |
Author | Halpern, Marcia | |
Author | Carius, Luciana | |
Author | Roma, Joyce | |
Author | Cardoso, Sandra Wagner | |
Author | Grinsztejn, Beatriz | |
Author | Veloso, Valdiléa G. | |
Author | Pacheco, Lucio | |
Author | Perazzo, Hugo | |
Access date | 2022-12-11T12:50:30Z | |
Available date | 2022-12-11T12:50:30Z | |
Document date | 2022 | |
Citation | PINTO, Laura et al. Effectiveness of Direct-acting Agents After Liver Transplantation A Real-life Study in Rio de Janeiro. Archives of medical research, v. 53, n. 6, p. 585-593, 2022. | en_US |
ISSN | 0188-4409 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/55906 | |
Language | eng | en_US |
Publisher | Elsevier | en_US |
Rights | restricted access | en_US |
Title | Effectiveness of Direct-acting Agents After Liver Transplantation A Real-life Study in Rio de Janeiro | en_US |
Type | Article | en_US |
DOI | 10.1016/j.arcmed.2022.09.001 | |
Abstract | Background: Data concerning hepatitis C virus (HCV) treatment using direct-acting agents (DAAs) post liver transplantation (LT) remains scarce in low- and average-income countries.
Aim of the study: To evaluate the safety and efficacy of post-LT HCV treatment using DAAs in Rio de Janeiro (Brazil), and to assess the course of hepatic biomarkers after sustained virological response (SVR).
Methods: Data from LT recipients with recurrent HCV treated using DAAs was retrospectively analyzed. HCV was defined by detectable HCV-RNA with elevated aminotransferases and/or histological signs of infection on liver biopsy post LT. SVR was defined as undetectable HCV-RNA 12 weeks after the end of treatment. Aspartate-to-Platelet Ratio Index (APRI) and Fibrosis-4 score (FIB-4) were calculated before treatment and after SVR.
Results: 116 patients (63% male, median age 62 years, 75% genotype 1 and 62% with hepatocellular carcinoma [HCC] prior to LT) were included. Cirrhosis was identified in the allograft of 21 subjects (18%). The overall SVR was 96.6% without differences in SVR proportion according to clinical/demographic characteristics, genotype or presence of cirrhosis. SVR rates were similar in individuals with and without HCC pre-LT (95.8% [95% CI: 87.6-98.7] vs. 97.7% [95% CI: 85.0-99.7%], p = 0.588). No serious adverse events were observed and the use of ribavirin was associated with at least one adverse event (OR = 8.71 [95% CI: 3.17-23.99]). SVR was associated with regression of APRI (OR = 26.00 [95% CI 4.27-1065.94]) and FIB-4 (OR = 15.00 [95% CI: 2.30-631.47]).
Conclusion: Post-LT HCV treatment with DAAs was safe and effective and associated with a significant decrease in hepatic biomarker levels after SVR. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil / Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Quinta D'Or Hospital. Liver Transplantation Group. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
Subject | Direct Acting Agents | en_US |
Subject | Hepatitis C virus | en_US |
Subject | Liver Transplantation | en_US |
Subject | Non-Invasive Methods | en_US |