Levels of tacrolimus after treatment for chronic hepatitis C with direct antiviral agents in solid organ transplant recipients
AbstractBackground and objective The main objective was to evaluate the impact of Hepatitis C Virus treatment with direct-acting antiviral agents on tacrolimus blood levels in recipients of kidney and heart allografts.Method We analysed Hepatitis C Virus infected adult patients who received tacrolimus as immunosuppressive maintenance therapy and received direct-acting antiviral agents treatment in a tertiary hospital with solid transplant multidisciplinary program in Madrid, Spain. Liver and renal function, tacrolimus dose and blood levels were analysed before and 12 weeks after the end of treatment.Results We identified 7 kidney and 2 heart transplant recipients. All patients achieved sustained virologic response at 24 weeks. At week 12 after treatment, all liver functionality tests improved significantly with no significant changes in renal function. A decrease in the tacrolimus blood level/dose ratio for every patient was observed (370.04 ± 253.93 vs. 186.44 ± 123.74 ng/mL per mg/kg;p
Conditions: End Stage Renal Disease; Hepatitis C Intervention: Drug: Glecaprevir/pibrentasvir Sponsor: Johns Hopkins University Not yet recruiting
Initial trials looking at the efficacy of kidney (KT) and liver transplantation (LT) in HIV-infected patients showed early graft and patient survival outcomes comparable to those in noninfected patients, except for patients with HCV co-infection. We hypothesized comparable long-term outcomes in the post-HCV direct acting agent (DAA) era.
Since the THINKER (Transplanting Hepatitis C Kidneys into Negative KidnEy Recipients) trial established that solid-organ transplantation from hepatitis C nucleic acid amplification test (NAT)+ kidney donors into hepatitis C –negative patients was possible without infecting recipients, an entirely new pool of organ donors became available.1 This era was ushered in by the advent of direct-acting antiviral agents that cure the vast majority of patients infected with hepatitis C. Over the last 5 decades, hepatitis C inf ection rates have dramatically fallen in the population but are now rising again due to the opioid epidemic.
TUESDAY, Sept. 8, 2020 -- New hepatitis C medications are allowing people to receive a kidney transplant from a deceased donor who had the liver disease -- a strategy aimed at getting more lifesaving organs to patients languishing on waitlists. Two...
PMID: 32894697 [PubMed - as supplied by publisher]
CONCLUSION: Targeted high-risk screening in the emergency department identified undiagnosed and untreated HCV carriers, but did not improve treatment rates. Other strategies need to be developed to improve linkage to care in high risk populations. PMID: 32921964 [PubMed - in process]
CONCLUSIONS: HCV antibody should not be considered routine screening for presence of infection in previously HCV naïve kidney transplant recipients receiving kidneys from HCV-infected donors, as only a modest percentage have antibody despite active viremia. The assessment of HCV viral load should be routine in all transplant recipients receiving organs from public health service increased risk donors. PMID: 32729359 [PubMed - in process]
Authors: Khan MU, Mahmoud MI, Butt AA Abstract INTRODUCTION: Hepatitis C virus (HCV) infection is associated with an increased incidence and progression of chronic kidney disease (CKD), as well as higher mortality in CKD and renal transplant patients. Direct acting antiviral agents (DAAs) have revolutionized the treatment of HCV, with viral eradication attained in 90-100% of treated patients. DAAs have an excellent safety and tolerability profile in CKD and renal transplant patients. AREAS COVERED: In this review, we discuss the association of HCV with incidence and progression of CKD as well as its effect on o...
Conclusion: Post-transplantation treatment of chronic HCV is preferred in KTRs. The sofosbuvir/daclatasvir regimen as an interferon-free therapy is a safe, effective option for HCV infection in pediatric KTRs, who can tolerate sofosbuvir/daclatasvir well and respond favorably without significant adverse events. PMID: 32606888 [PubMed]
Abstract The total number of end-stage kidney disease patients treated with dialysis in 2019 in Kuwait was 2230, with a 6% increase from the year before. Dialysis prevalence was 465 per million population (PMP) and dialysis incidence was100 PMP. Kuwaiti nationals represented 70% of the dialysis population and males represented 52%. Of the same population, 59% had diabetes. Hepatitis C virus affected