Curing Hepatitis C in Liver Transplant Recipients Is Associated with Changes in Immunosuppressant Use

摘要

Background and Aims:All-oral interlferon-free antivirals are highly effective in treating recurrent hepatitis C (HCV) infection in liver transplant (LT) recipients.The aim of the study was to assess immunosuppression needs after achieving a sustained viral response (SVR).Methods:We compared immunosuppression needs before and after achieving a SVR in adult LT recipients treated for recurrent HCV infection with alloral direct acting agents.Results:We identified 52 liver LT treated recipients who achieved a SVR.The median (25th and 75th percentile interquartile range [IQR]) age was 62 years (57.75,65).Most recipients received tacrolimus (TAC) for their immunosuppressant regimen.After achieving SVR,there was no statistically significant difference in daily dose of TAC unadjusted per weight (p ＞ 0.05).However,there was a statistically significant decrease in daily dose of TAC adjusted per weight,serum levels of TAC,and the product of glomerular filtration rate and TAC.No statistically significant differences in cyclosporine unadjusted/adjusted per weight daily dose or serum levels were noted.Conclusions:Immunosuppression needs were increased for those patients treated with TAC but not cyclosporine.LT recipients prescribed TAC require close monitoring after treatment completion to avoid potential risk of acute rejection.