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
|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|
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