Successful direct acting antiviral (DAA) treatment of HCV/HIV-coinfected patients before and after liver transplantation

  • Objectives: The aim of this multicenter retrospective study was to investigate safety and efficacy of direct acting antiviral (DAA) treatment in the rare subgroup of patients with HCV/HIV-coinfection and advanced liver cirrhosis on the liver transplant waiting list or after liver transplantation, respectively. Methods: When contacting 54 German liver centers (including all 23 German liver transplant centers), 12 HCV/HIV-coinfected patients on antiretroviral combination therapy were reported having received additional DAA therapy while being on the waiting list for liver transplantation (patient characteristics: Child-Pugh A (n = 6), B (n = 5), C (n = 1); MELD range 7–21; HCC (n = 2); HCV genotype 1a (n = 8), 1b (n = 2), 4 (n = 2)). Furthermore, 2 HCV/HIV-coinfected patients were denoted having received DAA therapy after liver transplantation (characteristics: HCV genotype 1a (n = 1), 4 (n = 1)). Results: Applied DAA regimens were SOF/DAC (n = 7), SOF/LDV/RBV (n = 3), SOF/RBV (n = 3), PTV/r/OBV/DSV (n = 1), or PTV/r/OBV/DSV/RBV (n = 1), respectively. All patients achieved SVR 12, in the end. In one patient, HCV relapse occurred after 24 weeks of SOF/DAC therapy; subsequent treatment with 12 weeks PTV/r/OBV/DSV achieved SVR 12. One patient underwent liver transplantation while on DAA treatment. Analysis of liver function revealed either stable parameters or even significant improvement during DAA therapy and in follow-up. MELD scores were found to improve in 9/13 therapies in patients on the waiting list for liver transplantation; in only 2 patients a moderate increase of MELD scores persisted at the end of follow-up. Conclusion: DAA treatment was safe and highly effective in this nation-wide cohort of patients with HCV/HIV-coinfection awaiting liver transplantation or being transplanted.

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Author:Julia M. Grottenthaler, Christoph R. Werner, Martina Steurer, Ulrich Spengler, Thomas Berg, Cornelius Engelmann, Heiner WedemeyerORCiDGND, Thomas von Hahn, Wolfgang Stremmel, Anita Pathil, Ulrich Seybold, Eckart Schott, Usha Blessin, Christoph SarrazinGND, Martin-Walter WelkerGND, Ellen Harrer, Stefan Scholten, Clemens Hinterleitner, Ulrich Manfred Lauer, Nisar Peter Malek, Christoph Peter Berg
Pubmed Id:
Parent Title (English):PLoS one
Place of publication:Lawrence, Kan.
Contributor(s):Chen-Hua Liu
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/06/06
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/06/07
Tag:Antiretroviral therapy; Antiretrovirals; Cirrhosis; HIV; HIV-1; Hepatitis C virus; Liver diseases; Liver transplantation
Issue:(6): e0197544
Page Number:12
First Page:1
Last Page:12
Copyright: © 2018 Grottenthaler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0