OUTCOMES OF SOFOSBUVIR AND RIBAVIRIN FOR THE TREATMENT OF HCV RECURRENCE AFTER LIVER TRANSPLANTATION

Background: Recurrent hepatitis occurs in the vast majority of HCV-positive recipients who are viremic

at the time of Liver Transplantation (LT). We evaluated safety and efficacy of all oral antiviral therapy

(Tx) with Sofosbuvir plus Ribavirin in a population of HCV G3-infected patients.

Methods: We prospectively enrolled 30 liver transplant patients who had recurrent hepatitis. They were

HCV RNA positive with fibrosis score F3 (21pts) or F4 (9pts) according to Fibroscan, 70% male, mean-age

50years, mean BMI 25. All patients were G3, 43% were receiving mycophenolate, 47% tacrolimus.

Patients received SOF 400mg/daily plus RBV(weight based: 1000 mg daily if<75 kg; 1200mg daily if ≥75

kg) for 24 weeks. Median time from LT to Tx 4.96years (0.25-14.25); mean baseline HCV RNA 6.62

log10IU/mL (3.4-7.9 log 10IU/mL); mean GFR 76 mL/min.

Results: All 30 patients completed 24-weeks of treatment. All 30 patients were HCVPCR negative at

week-4, week-12 and 29/30(96%) at week 24.The most common adverse events were fatigue, headache

and nausea. During Tx, 1 patient had variceal bleeding (day 100) and 1 died due to multi-organ failure

(day 120); 25% received blood transfusion or epoetin; 1 patient temporally discontinued RBV because of

skin rash. Minimal immunosuppression dose adjustments were required on Tx and no rejection episodes

were recorded.

Conclusions: In pts with severe HCV recurrence post-LT, an oral antiviral regimen using SOF plus RBV is

very well tolerated and easy to manage, while allowing rapid HCV clearance. This is our ongoing study.

Patients are under regular review to observe SVR.