Efficacy and safety of glecaprevir and pibrentasvir treatment for 8 or 12 weeks in patients with recurrent hepatitis C after liver transplantation: a Japanese multicenter experience

Yoshihide Ueda, Tsuyoshi Kobayashi, Toru Ikegami, Satoshi Miuma, Shugo Mizuno, Nobuhisa Akamatsu, Akinobu Takaki, Masatoshi Ishigami, Mitsuhisa Takatsuki, Yasuhiko Sugawara, Yoshihiko Maehara, Shinji Uemoto, Hiroshi Seno

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Efficacy of 8-week regimen with direct-acting antivirals (DAA) for patients with hepatitis C after liver transplantation has not been clarified. This study aimed to clarify the efficacy and safety of glecaprevir and pibrentasvir therapy for 8 and 12 weeks in Japanese patients with recurrent hepatitis C after liver transplantation. Methods: A cohort study of liver transplant recipients with recurrent hepatitis C treated with glecaprevir (300 mg/day) and pibrentasvir (120 mg/day) was performed at nine liver transplant centers in Japan. Results: Twenty-five patients with hepatitis C after liver transplantation were treated with glecaprevir and pibrentasvir. Twenty-four patients completed the treatment protocol; treatment was discontinued in one patient who had nausea at 3 days after the initiation of treatment. All the 24 patients who completed the 8- or 12-week treatment protocol achieved a sustained virological response 12 weeks after completion of treatment (SVR12). The SVR12 rates in patients with HCV genotype 1 and 2 were 100% (21 of 21 patients) and 75% (3 of 4 patients), respectively. All patients with prior DAA therapy failure (n = 6), jaundice (n = 4), and liver cirrhosis (n = 4) achieved SVR12. Seven of 8 patients (88%) with severe renal impairment achieved SVR12. Adverse events occurred in 6 of 25 patients (24%), including serious adverse events in 2 patients (8%). Treatment-related adverse events were nausea, pruritus, and mild renal dysfunction. Conclusions: Eight- or 12-week regimen of glecaprevir and pibrentasvir is efficacious and safe in patients with recurrent HCV infection after liver transplantation, even in difficult-to-treat populations, including patients with severe renal impairment, prior DAA experience, liver cirrhosis, or jaundice after liver transplantation.

Original languageEnglish
JournalJournal of Gastroenterology
DOIs
Publication statusPublished - Jan 1 2019

    Fingerprint

Keywords

  • Glecaprevir
  • Hepatitis C
  • Liver transplantation
  • Pibrentasvir

ASJC Scopus subject areas

  • Gastroenterology

Cite this