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Direct-acting antiviral agent-based regimen for HCV recurrence after combined liver-kidney transplantation: Results from the ANRS CO23 CUPILT study

Sébastien Dharancy 1, * Audrey Coilly 2, 3 Claire Fougerou-Leurent 4, 5 Christophe Duvoux 6 Nassim Kamar 7, 8 Vincent Leroy 9 Albert Tran 10 Pauline Houssel-Debry 5 Valérie Canva 11 Christophe Moreno 12 Filoména Conti Jérome Dumortier 13, 14 Vincent Di Martino 15 Sylvie Radenne 16 Victor de Ledinghen 17 Louis d'Alteroche 18 Christine Silvain 19 Camille Besch Philippe Perré Danielle Botta-Fridlund 20 Claire Francoz 21 François Habersetzer 22 Hélène Montialoux Armand Abergel 23 Maryline Debette-Gratien 24, 25 Alexandra Rohel 26 Emilie Rossignol 4 Didier Samuel 2, 3 Jean-Charles Duclos-Vallée 2, 3 Georges-Philippe Pageaux 27, 28 
Abstract : Hepatitis C virus (HCV) infection is associated with reduced patient survival following combined liver-kidney transplantation (LKT). The aim of this study was to assess the efficacy and safety of second-generation direct-acting antivirals (DAAs) in this difficult-to-treat population. The ANRS CO23 "Compassionate use of Protease Inhibitors in Viral C Liver Transplantation" (CUPILT) study is a prospective cohort including transplant recipients with recurrent HCV infection treated with DAAs. The present work focused on recipients with recurrent infection following LKT. The study population included 23 patients. All patients received at least one NS5B inhibitor (sofosbuvir) in their antiviral regimen an average of 90 months after LKT. Ninety-six percent of recipients achieved a sustained virological response (SVR) at week 12 (SVR12). In terms of tolerance, 39% of recipients presented with at least one serious adverse event. None of the patients experienced acute rejection during therapy and there were no deaths during follow-up. The glomerular filtration rate (GFR) decreased significantly from baseline to the end of therapy. However, this study did not show that the decline in GFR persisted over time or that it was directly related to DAAs. The DAA-based regimen is well tolerated with excellent results in terms of efficacy. It will become the gold standard for the treatment of recurrent HCV following LKT.
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Submitted on : Thursday, January 25, 2018 - 11:29:45 AM
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Sébastien Dharancy, Audrey Coilly, Claire Fougerou-Leurent, Christophe Duvoux, Nassim Kamar, et al.. Direct-acting antiviral agent-based regimen for HCV recurrence after combined liver-kidney transplantation: Results from the ANRS CO23 CUPILT study. American Journal of Transplantation, Wiley, 2017, 17 (11), pp.2869-2878. ⟨10.1111/ajt.14490⟩. ⟨hal-01640061⟩



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