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Sofosbuvir plus Simeprevir Treatment of Recurrent
Genotype 1 Hepatitis C after Liver Transplant
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Clinical Transplantation Sept 2015
Patients with recurrent hepatitis C (HCV) infection post liver-transplant can be difficult to treat safely and effectively. A prior (COSMOS) study in non-transplant HCV patients, using sofosbuvir plus simeprevir, had high efficacy and tolerability in treating HCV genotype 1 patients, even prior non-responders to interferon therapy and those with cirrhosis. Our aim was to evaluate the efficacy of sofosbuvir and simeprevir in genotype 1 HCV post-liver transplant patients.
In this prospective, observational study, patients received sofosbuvir 400mg plus simeprevir 150mg daily for 12 weeks without ribavirin. The primary endpoint was a sustained virologic response 12 weeks after the end of therapy. Forty-two patients completed treatment. Twenty-six percent started treatment <6 months post-liver transplant. Nineteen percent of the included patients had cirrhosis, 14% with decompensation. At week 4 on treatment, 21% of patients had detectable virus but at the end of treatment, 100% were undetectable. Twelve weeks after the end of treatment, 95% of patients had undetectable hepatitis C. The regimen was generally well tolerated.
The oral regimen of sofosbuvir plus simeprevir without ribavirin is efficacious and well tolerated in the treatment of genotype 1 hepatitis C patients post-liver transplant.


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