Efficacy and safety of direct-acting antiviral therapy in previous hard-to-treat patients with recurrent hepatitis C virus infection after liver transplantation: a real-world cohort

Figures & data

Figure 1 Flowchart showing the selection of the treatment cohort.

Abbreviations: LT, liver transplantation; HCV, hepatitis C virus; DAA, direct-acting antiviral; SVR, sustained virological response; IFN, interferon.

Figure 2 Survival of patients after liver transplantation with or without HCV (A) and GT1 vs non-GT1 (B).

Abbreviations: HCV, hepatitis C virus; OLT, orthotopic liver transplantation; GT, genotype.

Table 1 Patient demographics at baseline (quantitative data are given as medians and interquartile range in parentheses)

Characteristics	Overall
Sample size	n=37
Male	73.0% (n=27)
Age	59.8 years (57.1–66.2)
Time since OLT	4.9 years (1.1–7.9)
HCV genotype
1	67.6% (n=25)
2	5.4% (n=2)
3	21.6% (n=8)
4	2.7% (n=1)
5	2.7% (n=1)
Treatment regimen
IFN	8.1% (n=3)
RBV	51.4% (n=24)
SOF	97.3% (n=36)
SMV	5.4% (n=2)
LDV	45.9% (n=17)
DCV	21.6% (n=8)
3D	2.7% (n=1)
Duration of treatment
12 weeks	62.2% (n=23)
24 weeks	37.8% (n=14)
Stage of fibrosis
From no to mild (≤F2)	86.5% (n=32)
Severe (≥F3)	13.5% (n=5)
MELD score	8 (7–11)
HCV-RNA	2.2×10^6 lU/mL (1.0×10^6 to 5.5×10^6)
Bilirubin	0.78 mg/dL (0.63–1.02)
Hemoglobin	13.7 g/dL (11.8–15.0)
ALT	44.0 IU/mL (32.0–71.8)
AST	45.0 IU/mL (26.0–69.0)
γGT	90.0 IU/mL (45.5–193.3)
Albumin	38.0 g/L (33.5–42.5)
Ferritin	148.5 μg/dL (60.0–620.5)
Creatinine	1.03 mg/dL (0.94–1.42)

Abbreviations: OLT, orthotopic liver transplantation; HCV, hepatitis C virus; IFN, interferon; RBV, ribavirin; SOF, sofosbuvir; SMV, simeprevir; LDV, ledipasvir; DCV, daclatasvir; 3D, paritaprevir/ritonavir with ombitasvir and dasabuvir; MELD, model for end-stage liver disease; RNA, ribonucleic acid; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ-GT, gamma-glutamyl transferase.

Figure 3 Therapeutic regimens sorted by treatment duration.

Abbreviations: SOF, sofosbuvir; LDV, ledipasvir; RBV, ribavirin; SMV, simeprevir; DAA, direct-acting antiviral; DCV, daclatasvir; IFN, interferon; 3D, paritaprevir/ritonavir with ombitasvir and dasabuvir.

Figure 4 Biochemical response to DAA therapy. The activities of ALT (A), AST (B), γ-GT (C), and the serum levels of total bilirubin (D) declined within the observation period.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; DAA, direct-acting antiviral; γ-GT, gamma-glutamyl transferase; EoT, end of treatment; SVR12, sustained virological response 12 weeks after EoT.