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ORIGINAL RESEARCH article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1460372

Efficacy of Direct Acting Antivirals (DAA) Therapy in Patients with Recurrent Hepatitis C after Liver and Kidney Transplantation: a crosssectional study

Provisionally accepted
Mehdi Kashani Mehdi Kashani 1Mehdi Karimi Mehdi Karimi 2*Alireza Sharifi Rayeni Alireza Sharifi Rayeni 3*Mohammad Ali Azizi Nadian Mohammad Ali Azizi Nadian 4*Masoud Mortezazadeh Masoud Mortezazadeh 5*Amirhossein Parsaei Amirhossein Parsaei 4*Nooshin Abolghasemi Nooshin Abolghasemi 6*Seyyed Taher Seyyed Mahmoudi Seyyed Taher Seyyed Mahmoudi 7*Abbas Mofidi Abbas Mofidi 8*Niyousha Shirsalimi Niyousha Shirsalimi 9*
  • 1 Sina Hospital, Department of Gastroenterology, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  • 2 Bogomolets National Medical University, Kyiv, Ukraine
  • 3 Modarres Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
  • 4 School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  • 5 Sina Hospital, Department of Internal Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Alborz, Iran
  • 6 Department of Pharmacology, Islamic Azad University - Pharmaceutical Sciences Branch (IAUPS), Tehran, Iran
  • 7 Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  • 8 Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
  • 9 Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

The final, formatted version of the article will be published soon.

    Background & objectives: Direct-acting antiviral (DAA) agents are now widely used to treat patients with hepatitis C infection (HCV) and effectively increase their sustained virologic response (SVR). However, the literature seems to lack or deficient evidence of DAA efficacy in more complicated patients, especially those with HCV reinfection after liver transplantation (LT) or liver-kidney (hepatorenal) transplantation (LKT). This study aimed to retrospectively evaluate the effectiveness of two different DAA regimens in LT and LKT patients with HCV reinfection.This cross-sectional study was conducted at three hospitals in Tehran, Iran, from 2014 to 2020, enrolling 53 patients with recurrent HCV infection after LT (n=35) or LKT (n=18). Patients were treated for 12 weeks with one of two DAA regimens: 37 patients (70%) received Daclatasvir and Sofosbuvir (SOF+DCV), while 16 patients (30%) received Sofosbuvir and Ledipasvir (SOF+LDV). Ribavirin (RBV) was added as an adjunct antiviral in 28 patients (52.8%). To assess the SVR, all patients were followed for 12 weeks after treatment.Results: Both DAA regimens were well-tolerated and effective, with 94.6% (35 of 37) achieving SVR-12 in the SOF+DCV group and 93.8% (15 of 16) in the SOF+LDV group.Additionally, SVR-12 rates were promising across treatment durations, with 93.9% (31 of 33) in the 12-week group and 95% (19 of 20) in the 24-week group achieving undetectable HCV RNA. No significant difference in SVR was observed between the two regimens (p=0.439).The DAA-based therapeutic regimen was well tolerated and showed significant effectiveness in achieving the virologic response in patients with HCV reinfection after LT or LKT.

    Keywords: Viral Hepatitis, Hepatitis C virus, HCV, Direct-acting antiviral, antivirals, Transplantation

    Received: 06 Jul 2024; Accepted: 05 Sep 2024.

    Copyright: © 2024 Kashani, Karimi, Sharifi Rayeni, Azizi Nadian, Mortezazadeh, Parsaei, Abolghasemi, Seyyed Mahmoudi, Mofidi and Shirsalimi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Mehdi Karimi, Bogomolets National Medical University, Kyiv, Ukraine
    Alireza Sharifi Rayeni, Modarres Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
    Mohammad Ali Azizi Nadian, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
    Masoud Mortezazadeh, Sina Hospital, Department of Internal Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Alborz, Iran
    Amirhossein Parsaei, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
    Nooshin Abolghasemi, Department of Pharmacology, Islamic Azad University - Pharmaceutical Sciences Branch (IAUPS), Tehran, Iran
    Seyyed Taher Seyyed Mahmoudi, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
    Abbas Mofidi, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
    Niyousha Shirsalimi, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

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