Management of telaprevir-based triple therapy for hepatitis C virus recurrence post liver transplant  

作　　者：Kerstin Herzer Angela Papadopoulos-Khn Anne Achterfeld Ali Canbay Katja Piras-Straub Andreas Paul Andreas Walker Jrg Timm Guido Gerken 

机构地区：[1]Department of Gastroenterology and Hepatology, University Hospital Essen [2]Department of General-Visceral and Transplantation Surgery, University Hospital Essen [3]Institute for Virology, Heinrich Heine University

出　　处：《World Journal of Hepatology》2015年第9期1287-1296,共10页世界肝病学杂志（英文版）（电子版）

基　　金：The Federal funds for the National Reference Centre for Hepatitis C,Herzer K has received grant support from Astellas,Biotest and Novartis and been a consultant/speaker for Abb Vie,Biotest,Bristol-Myers Squibb,Gilead Sciences,Janssen Pharmaceuticals,Novartis,and Roche;Gerken G has been a consultant/speaker for Abb Vie,Bristol-Myers Squibb,Gilead Sciences,Janssen Pharmaceuticals and Roche

摘　　要：AIM: To characterize management of telaprevir(TVR)-based triple therapy of hepatitis C virus(HCV) reinfection after liver transplantation(LT).METHODS: We retrospectively analyzed safety and efficacy of telaprevir- based triple therapy in a single center cohort of 19 patients with HCV genotype(GT) 1 recurrence after LT, with respect to factors possibly predicting sustained viral response(SVR) or non-SVR. All patients were treated with TVR, pegylated(PEG) and ribavirine(RBV) for 12 wk followed by a dual phase with PEG/RBV for 12 wk in 7 patients and for 36 wk in 5 patients. RESULTS: In total 11/19(58%) of patients achieved a sustained response. All(11/11) SVR patients showed a rapid viral response at treatment weeks 4 and 11/14 rapid virological response(RVR) patients achieved SVR. Notably, all(7/7) patients who completed 48 wk of therapy and 80%(4/5) patients who completed 24 wk of therapy achieved SVR24. Treatment failure was significantly(P > 0.049) more frequent in GT1 a infection(5/7) compared to GT1b(3/12) infection and was associated with emergence of resistance-associated mutations in the NS3 protease domain. Bilirubin level at baseline is also related to SVR(P > 0.030). None of the patients had to discontinue treatment due to side effects. CONCLUSION: RVR, GT and bilirubin are clearly related to achievement of SVR. Providing a thorough patient selection and monitoring, a full course of TVR-based triple therapy in LT patients is feasible and achieves high SVR rates.AIM To characterize management of telaprevir （TVR）-based triple therapy of hepatitis C virus （HCV） reinfectionafter liver transplantation （LT）.METHODS： We retrospectively analyzed safety andefficacy of telaprevir - based triple therapy in a singlecenter cohort of 19 patients with HCV genotype （GT）1 recurrence after LT, with respect to factors possiblypredicting sustained viral response （SVR） or non-SVR.All patients were treated with TVR, pegylated （PEG）and ribavirine （RBV） for 12 wk followed by a dual phasewith PEG/RBV for 12 wk in 7 patients and for 36 wk in5 patients.RESULTS： In total 11/19 （58%） of patients achieveda sustained response. All （11/11） SVR patients showeda rapid viral response at treatment weeks 4 and 11/14rapid virological response （RVR） patients achievedSVR. Notably, all （7/7） patients who completed 48 wk of therapy and 80% （4/5） patients who completed 24 wk of therapy achieved SVR24. Treatment failurewas significantly （P 〉 0.049） more frequent in GT1ainfection （5/7） compared to GT1b （3/12） infection andwas associated with emergence of resistance-associatedmutations in the NS3 protease domain. Bilirubin levelat baseline is also related to SVR （P 〉 0.030）. None ofthe patients had to discontinue treatment due to sideeffects.CONCLUSION： RVR, GT and bilirubin are clearly relatedto achievement of SVR. Providing a thorough patientselection and monitoring, a full course of TVR-basedtriple therapy in LT patients is feasible and achieves highSVR rates.

关 键 词：Liver transplantation TELAPREVIR HEPATITISC VIRUS RECURRENCE PREDICTORS Hepatitis C VIRUS therapy 

分 类 号：R657.3[医药卫生—外科学]