Retrospective-prospective study of safety and efficacy of sofosbuvir-based direct-acting antivirals in HIV/HCV-coinfected participants with decompensated liver disease pre- or post-liver transplant
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons..
Direct-acting antiviral (DAA) therapy has transformed the management of human immunodeficiency virus (HIV) and hepatitis C (HCV) coinfected patients with advanced liver disease. STOP-Coinfection was a multicenter prospective and retrospective, open-label study using sofosbuvir-based DAA therapy to treat HIV/HCV-coinfected participants pre- or post-liver transplant (LT). Sixty-eight participants with end-stage liver disease (Child-Turcotte-Pugh score ≥7 and Model for End-Stage Liver Disease score 6-29) were enrolled, 26 had hepatocellular carcinoma. Forty-two participants were treated pre-LT and 26 post-LT. All participants completed therapy without need for dose reduction or transfusion; eight required two or more courses of therapy. Ninety-three percent achieved a sustained virologic response and DAA therapy was well tolerated. Despite HCV cure, 12 end-stage liver disease participants required subsequent LT, 7 for decompensated liver disease. Thirteen participants died, 10 with decompensated liver disease pre-LT and three post-LT. Overall, transplant free survival was 42.8% at 4 years and post-LT survival was 87.9% at 5 years. We conclude that sofosbuvir-based DAA therapy is safe and highly effective in HCV-HIV patients with decompensated liver disease and post-LT, with post-LT survival rates comparable to other indications. This removes one of the last barriers to liver transplantation in this challenging cohort of recipients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 21(2021), 5 vom: 06. Mai, Seite 1780-1788 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peters, Marion G [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 18.06.2021 Date Revised 24.01.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ajt.16427 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318437864 |
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| 100 | 1 | |a Peters, Marion G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Retrospective-prospective study of safety and efficacy of sofosbuvir-based direct-acting antivirals in HIV/HCV-coinfected participants with decompensated liver disease pre- or post-liver transplant |
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| 500 | |a Date Revised 24.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons. | ||
| 520 | |a Direct-acting antiviral (DAA) therapy has transformed the management of human immunodeficiency virus (HIV) and hepatitis C (HCV) coinfected patients with advanced liver disease. STOP-Coinfection was a multicenter prospective and retrospective, open-label study using sofosbuvir-based DAA therapy to treat HIV/HCV-coinfected participants pre- or post-liver transplant (LT). Sixty-eight participants with end-stage liver disease (Child-Turcotte-Pugh score ≥7 and Model for End-Stage Liver Disease score 6-29) were enrolled, 26 had hepatocellular carcinoma. Forty-two participants were treated pre-LT and 26 post-LT. All participants completed therapy without need for dose reduction or transfusion; eight required two or more courses of therapy. Ninety-three percent achieved a sustained virologic response and DAA therapy was well tolerated. Despite HCV cure, 12 end-stage liver disease participants required subsequent LT, 7 for decompensated liver disease. Thirteen participants died, 10 with decompensated liver disease pre-LT and three post-LT. Overall, transplant free survival was 42.8% at 4 years and post-LT survival was 87.9% at 5 years. We conclude that sofosbuvir-based DAA therapy is safe and highly effective in HCV-HIV patients with decompensated liver disease and post-LT, with post-LT survival rates comparable to other indications. This removes one of the last barriers to liver transplantation in this challenging cohort of recipients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a antibiotic: antiviral | |
| 650 | 4 | |a cirrhosis | |
| 650 | 4 | |a clinical research / practice | |
| 650 | 4 | |a infection and infectious agents - viral: hepatitis C | |
| 650 | 4 | |a liver transplantation / hepatology | |
| 650 | 4 | |a recurrent disease | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 650 | 7 | |a Sofosbuvir |2 NLM | |
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| 700 | 1 | |a Terrault, Norah |e verfasserin |4 aut | |
| 700 | 1 | |a Amara, Dominic |e verfasserin |4 aut | |
| 700 | 1 | |a Husson, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Huprikar, Shirish |e verfasserin |4 aut | |
| 700 | 1 | |a Florman, Sander |e verfasserin |4 aut | |
| 700 | 1 | |a Sulkowski, Mark S |e verfasserin |4 aut | |
| 700 | 1 | |a Durand, Christine M |e verfasserin |4 aut | |
| 700 | 1 | |a Luetkemeyer, Anne F |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers, Rodney |e verfasserin |4 aut | |
| 700 | 1 | |a Grab, Joshua |e verfasserin |4 aut | |
| 700 | 1 | |a Haydel, Brandy |e verfasserin |4 aut | |
| 700 | 1 | |a Blumberg, Emily |e verfasserin |4 aut | |
| 700 | 1 | |a Dove, Lorna |e verfasserin |4 aut | |
| 700 | 1 | |a Emond, Jean |e verfasserin |4 aut | |
| 700 | 1 | |a Olthoff, Kim |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Coleman |e verfasserin |4 aut | |
| 700 | 1 | |a Fishbein, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Masur, Henry |e verfasserin |4 aut | |
| 700 | 1 | |a Stock, Peter G |e verfasserin |4 aut | |
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