10 Nov Eradicating Hepatitis C In Liver Transplant Patients With Less Toxic Combination Therapy
Medical Research: What is the background for this study? What are the main findings?
Dr. Pungpapong: This study reports our multicenter experience from Mayo Clinic’s three sites using sofosbuvir and simeprevir with/without ribavirin for 12 weeks to treat hepatitis C genotype 1 recurrence after liver transplantation. We found that this all-oral interferon-free antiviral regimen was very well tolerated with minimal to mild side effects. It required minimal dose adjustment of immunosuppression and no episode of acute rejection occurred. Overall, sustained virologic response rate was very high, more than 90 percent.
Medical Research: What should clinicians and patients take away from your report?
Dr. Pungpapong: This study is one of the first reports to prove the concept that all-oral interferon-free antiviral treatment for hepatitis C genotype 1 recurrence after liver transplantation is feasible with high efficacy and mild side effects. The results were comparable to those of non-liver transplantation setting, except response rate was slightly lower in the liver transplant recipients with genotype 1a and advanced fibrosis. By removing interferon from the treatment regimen, the risk of rejection was reduced substantially. Eradication of hepatitis C recurrence after liver transplantation is expected to improve both graft and patient survivals after liver transplantation.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Pungpapong: Several new oral direct-acting antiviral agents against hepatitis C virus will likely be approved and available for clinical practice in the next few years. Many combination regimens using these agents are expected to provide similar results. Future studies will clarify which combination regimen yields highest efficacy with the least side effects, and possibly requires shorter duration of treatment.