[HCV reinfection after liver transplantation - management and first experiences with telaprevir-based triple therapy]. / HCV-Reinfektion nach Lebertransplantation. Management und erste Ergebnisse mit der Telaprevir-basierten Triple-Therapie.
Dtsch Med Wochenschr
; 138(36): 1759-64, 2013 Sep.
Article
em De
| MEDLINE
| ID: mdl-24002874
ABSTRACT
BACKGROUND AND OBJECTIVE:
The management of hepatitis C virus (HCV) recurrence after liver transplantation (LTx) is a major challenge in patient care. For patients with HCV GT1, treatment standard with pegylated interferon (PEG-IFN) and ribavirin (RBV) has been augmented in 2011 by first generation protease inhibitors (PI), telaprevir (TVR) and boceprevir (BOC). We report our first experiences with TVR-based triple therapy in patients with GT1-reinfection of the graft. PATIENTS ANDMETHOD:
13 patients with histologically proven HCV GT1-reinfection of the graft received 12 weeks of PEG-IFN/RBV/TVR followed by 12 weeks of PEG-IFN/ RBV only. During the triple therapy phase immune suppression was tightly monitored, and the patients were also closely monitored for side effects.RESULTS:
The dosage of immunosuppressants had to be reduced significantly (TAC 30-fold; CSA 3,5-fold). Stable levels were achieved by daily or over-daily dosing of a special size application of 0,1 mg tacrolimus (Tac) bid or a minimal dose of 10 mg cyclosporine (CSA) bid or qd, respectively. In all patients hematological side effects were observed, 65 % of which required RBV dose reduction, administration of erythropoietin or blood transfusions. Increase of kidney retention values requiring infusions occurred in 50 %. All side effects were reversible. There were no early discontinuations of therapy. An early viral response (EVR) with viral decline below limit of detection was noted at week 12 in 9/13 patients and at week 12 in further 3 patients.CONCLUSION:
Our preliminary results show high EVR response rates of TVR-based triple therapy in LTx patients with HCV-GT1 re-infection.
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Base de dados:
MEDLINE
Assunto principal:
Antivirais
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Oligopeptídeos
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Polietilenoglicóis
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Complicações Pós-Operatórias
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Ribavirina
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Transplante de Fígado
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Interferon-alfa
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Hepatite C Crônica
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
De
Revista:
Dtsch Med Wochenschr
Ano de publicação:
2013
Tipo de documento:
Article