Clinical efficacy of direct-acting antiviral therapy for recurrent hepatitis C virus infection after liver transplantation in patients with hepatocellular carcinoma

• 作者: Ahmed Omar Kaseb FasihaKanwal John Alan Goss Maha Mohsen Kamal El-Din Manal Hassan Mohamed Mohamed Bahaa El-Din Mohamed Saleh Ismail Osama Aboelfotoh El Sayed Prasun Kumar Jalal Saira Aijaz Khaderi Wael Ahmed Yousry
• 来源期刊: 世界肝病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Direct-acting antiviral Liver transplant Hepatocellular carcinoma RECURRENCE
• 年，卷（期）: 2020,（9）
• 页码范围: 628-640
• 页数: 13页
• 分类号: R73

摘要

BACKGROUND Recurrent hepatitis C virus(HCV)infection of transplanted liver allografts is universal in patients with detectable HCV viremia at the time of transplantation.Direct-acting antiviral(DAA)therapy has been adopted as the standard of care for recurrent HCV infection in the post-transplant setting.However,there are insufficient data regarding its efficacy in liver transplant(LT)recipients with a history of hepatocellular carcinoma(HCC),and the risk of HCC recurrence after DAA therapy is unknown.predictors of DAA treatment failure and HCC recurrence in LT recipients.METHODS A total of 106 LT recipients given DAAs for recurrent HCV infection from 2015 to 2019 were identified(68 with and 38 without HCC).Descriptive statistics and logistic regression models were used to estimate the multivariate odds ratios and respective 95%confidence intervals for predictors of treatment failure and HCC recurrence.RESULTS Six patients(6%)experienced DAA therapy failure post-LT and 100(94%)had a sustained virologic response at follow-up week 12.A high alanine transaminase level>35 U/L at treatment week 4 was a significant predictor of treatment failure.Relapse to pre-LT DAA therapy is a predictor of post-LT HCC recurrence,P=0.04.DAA relapse post-LT was also associated with post-transplantation HCC recurrence,P=0.05.CONCLUSION DAAs are effective and safe in the treatment of recurrent HCV infection in LT recipients with history of HCC.Relapse to pre-and post-LT DAA therapy is associated with post-transplantation HCC recurrence.