Publication Date
9-27-2020
Journal
World Journal of Hepatology
DOI
10.4254/wjh.v12.i9.628
PMID
33033569
PMCID
PMC7522560
PubMedCentral® Posted Date
9-27-2020
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Direct-acting antiviral, Liver transplant, Hepatocellular carcinoma, Recurrence
Abstract
BACKGROUND: Recurrent hepatitis C virus (HCV) infection of transplanted liver allografts is universal in patients with detectable HCV viremia at the time of transplantation. Direct-acting antiviral (DAA) therapy has been adopted as the standard of care for recurrent HCV infection in the post-transplant setting. However, there are insufficient data regarding its efficacy in liver transplant (LT) recipients with a history of hepatocellular carcinoma (HCC), and the risk of HCC recurrence after DAA therapy is unknown.
AIM: To demonstrate predictors of DAA treatment failure and HCC recurrence in LT recipients.
METHODS: A total of 106 LT recipients given DAAs for recurrent HCV infection from 2015 to 2019 were identified (68 with and 38 without HCC). Descriptive statistics and logistic regression models were used to estimate the multivariate odds ratios and respective 95% confidence intervals for predictors of treatment failure and HCC recurrence.
RESULTS: Six patients (6%) experienced DAA therapy failure post-LT and 100 (94%) had a sustained virologic response at follow-up week 12. A high alanine transaminase level > 35 U/L at treatment week 4 was a significant predictor of treatment failure. Relapse to pre-LT DAA therapy is a predictor of post-LT HCC recurrence,
CONCLUSION: DAAs are effective and safe in the treatment of recurrent HCV infection in LT recipients with history of HCC. Relapse to pre- and post-LT DAA therapy is associated with post-transplantation HCC recurrence.
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Digestive System Diseases Commons, Gastroenterology Commons, Hepatology Commons, Medical Sciences Commons, Oncology Commons
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