RT Journal Article
T1 Efficacy and safety of daclatasvir-based antiviral therapy in hepatitis C virus recurrence after liver transplantation. Role of cirrhosis and genotype 3. A multicenter cohort study.
A1 Salcedo, Magdalena
A1 Prieto, Martín
A1 Castells, Lluís
A1 Pascasio, Juan Manuel
A1 Montero Alvarez, Jose Luis
A1 Fernández, Inmaculada
A1 Sánchez-Antolín, Gloria
A1 González-Diéguez, Luisa
A1 García-Gonzalez, Miguel
A1 Otero, Alejandra
A1 Lorente, Sara
A1 Espinosa, Maria Dolores
A1 Testillano, Milagros
A1 González, Antonio
A1 Castellote, Jose
A1 Casafont, Fernando
A1 Londoño, Maria-Carlota
A1 Pons, Jose Antonio
A1 Molina Pérez, Esther
A1 Cuervas-Mons, Valentín
A1 Pascual, Sonia
A1 Herrero, Jose Ignacio
A1 Narváez, Isidoro
A1 Vinaixa, Carmen
A1 Llaneras, Jordi
A1 Sousa, Jose Manuel
A1 Bañares, Rafael
K1 Model for End-Stage Liver Disease
K1 daclatasvir
K1 efficacy and safety
K1 recurrence of HCV
K1 survival prognostic model
AB Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion. The primary end point was sustained virological response (SVR) at week 12. A multivariate analysis of predictive factors of mortality was performed. Intention-to-treat (ITT) and per-protocol SVR were 93.05% and 96.9%. ITT-SVR was lower in cirrhosis (n = 163) (96.4% vs. 89.6% P = 0.017); the SVR in genotype 3 (n = 91) was similar, even in advanced fibrosis (96.7% vs. 88%, P = 0.2). Ten patients (3%) experienced virological failure. Therapy was stopped in 18 patients (5.44%), and ten died during treatment. A total of 22 patients (6.6%) died. Albumin (HR = 0.376; 95% CI 0.155-0.910) and baseline MELD (HR = 1.137; 95% CI: 1.061-1.218) were predictors of death. DCV-based DAA treatment is efficacious and safe in patients with HCV infection after LT. Baseline MELD score and serum albumin are predictors of survival irrespective of viral response.
YR 2017
FD 2017-07-27
LK http://hdl.handle.net/10668/11296
UL http://hdl.handle.net/10668/11296
LA en
DS RISalud
RD Apr 12, 2025