Treatment of Hepatitis C Infection with Direct-Acting Antiviral Agents in Liver-Transplant Patients: A Systematic Review and Meta-Analysis
| Author | Mohammad Saeid Rezaee-Zavareh | en |
| Author | Khashayar Hesamizadeh | en |
| Author | Heidar Sharafi | en |
| Author | Seyed Moayed Alavian | en |
| Orcid | Heidar Sharafi [0000-0001-9177-9117] | en |
| Orcid | Seyed Moayed Alavian [0000-0002-4443-6602] | en |
| Issued Date | 2017-06-30 | en |
| Abstract | Context: Recurrence of hepatitis C virus (HCV) infection after liver transplantation (LT) can be prevented, using antiviral therapy and new treatment regimens. Combination of protease, NS5A, and NS5B inhibitors, with or without pegylated-interferon and ribavirin (PEG-IFN/RBV), results in significantly high rates of sustained virologic response (SVR) among post-LT patients with HCV infection. In this study, we aimed to assess the efficacy of direct-acting antiviral (DAA) regimens in post-LT patients with HCV infection. Evidence Acquisition: We conducted a systematic search in electronic databases to detect eligible studies on DAA treatments after LT. We evaluated English-language studies, including clinical trials and cohort studies, which used antiviral DAA regimens (with or without PEG-IFN/RBV) and reported SVR rates at 12 weeks after the end of treatment (SVR12). After data extraction, the pooled SVRs were calculated, using STATA version 11. Results: A total of 35 studies with various HCV genotypes were included in our analysis. Due to the small sample size and lack of suitable data on HCV genotypes 2 - 6, the meta-analysis was only conducted among patients with HCV genotype 1; the results of other studies were also obtained. SVR12 rates ranged from 91% to 97% in patients with 12- or 24-week sofosbuvir (SOF)/simeprevir (SMV) ± RBV, SOF/ledipasvir (LDV) ± RBV, and SOF/daclatasvir (DCV) ± RBV regimens. The minimum SVR12 rate was found in patients receiving SMV plus PEG-IFN/RBV (59%; 95% Confidence Interval, 49 - 68). Conclusions: Administration of new HCV DAA regimens can prevent post-LT HCV infection. The combination of SOF/DCV and SOF/LDV, with or without RBV, for 12 or 24 weeks can produce high rates of SVR12 in post-LT HCV patients in different settings. | en |
| DOI | https://doi.org/10.5812/hepatmon.12324 | en |
| Keyword | Hepatitis C | en |
| Keyword | Therapy | en |
| Keyword | Direct-Acting Antiviral Agents | en |
| Keyword | Liver Transplantation | en |
| Keyword | Meta-Analysis | en |
| Publisher | Brieflands | en |
| Title | Treatment of Hepatitis C Infection with Direct-Acting Antiviral Agents in Liver-Transplant Patients: A Systematic Review and Meta-Analysis | en |
| Type | Review Article | en |
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