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Journal of Liver: Disease & TransplantationISSN: 2325-9612

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Research Article, J Liver Dis Transplant Vol: 4 Issue: 2

Daclatasvir/Asunaprevir Therapy Provides High Tolerability and Effectiveness for HCV-Positive Kidney Transplant Recipients

Tomomi Kogiso1*, Etsuko Hashimoto1, Kuniko Yamamoto1, Yuichi Ikarashi1, Kazuhisa Kodama1, Makiko Taniai1, Nobuyuki Torii1, Kazunari Tanabe2, Hideki Ishida2, Shohei Fuchinoue3 and Katsutoshi Tokushige1
1Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women’s, Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
2Department of Urology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
3Department of Surgery, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
Corresponding author : Tomomi Kogiso
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women’s, Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan,
Tel: +81-3-3353-8111; Fax: +81-3-5269-7507
E-mail: [email protected]
Received: September 16, 2015 Accepted: November 09, 2015 Published: November 13, 2015
Citation: Kogiso T, Hashimoto E, Yamamoto K, Ikarashi Y, Kodama K, et al. (2015) Daclatasvir/Asunaprevir Therapy Provides High Tolerability and Effectiveness for HCV-Positive Kidney Transplant Recipients. J Liver: Dis Transplant 4:2. doi:10.4172/2325-9612.1000131

Abstract

Background/Aims: Hepatitis C virus (HCV) infection is not rare in kidney transplant (KT) recipients. Interferon (IFN)-based therapies are generally contraindicated because IFN can induce severe rejection of the allograft. Here, we report five cases those who underwent therapy with direct-acting antiviral drugs (DAAs) after KT and evaluated their clinical outcomes.
Patients/Methods: The five patients [the median age; 55 (49- 71) years, 3 males], were treated with NS5A and NS3 proteasetargeted DAA (daclatasvir, DCV and asunaprevir, ASV) therapy for 24 weeks after KT. The immunosuppressants prescribed were corticosteroids/mammalian target of rapamycin, tacrolimus, and mycophenolate mofetil or azathioprine.
Results: In all cases, the acquired HCV was serological type 1 with the L31 or Y93 wild-type strain and the median HCV RNA level was 6.5 (5.7-6.7) log IU/mL. The median estimated glomerular filtration rate (eGFR) was 39 (30-58) mL/min/1.73 m2. All treated cases achieved a sustained virological response (SVR). Therapeutic drug monitoring of tacrolimus required slight adjustments of the tacrolimus dose. Regarding adverse events, a low-grade fever and mild renal dysfunction were observed in one case at 3 months. Despite withdrawing the treatment, this case still achieved SVR. The other cases showed no severe adverse events in liver or renal function.
Conclusions: An IFN-free regimen of DCV/ASV therapy provided high tolerability and effectiveness in HCV-positive KT recipients, even under immunosuppressive conditions

Keywords: Kidney transplantation (KT); Direct-acting antiviral drugs (DAAs); Daclatasvir (DCV) and Asunaprevir (ASV); Tolerability; Effectiveness

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