Interferon-free regimens for the treatment of hepatitis C virus in liver transplant candidates or recipients

Table 1 Main characteristics of the approved direct acting antivirals that are currently used in interferon-free regimens for the treatment of hepatitis C

DAA (commercial name), dose	Category	Dose adjustment in liver or renal impairment	Antiviral activity	CNIs co-administration	Co-administration should be avoided
Sofosbuvir (Sovaldi®), tablet 400 mg, once daily	NUC NS5B polymerase inhibitor	No change in hepatic impairment Contraindicatedin patients with GFR < 30 mL/min	Genotypes 1-6, High genetic barrier	No change	P-glycoprotein inducers (Anticonvulsants: carbamazepine, oxcarbazepine, phenobarbital, phenytoin; Antimycobacterials: rifampin, rifabutin, rifapentin; St. John’s wort; HIV drugs: Tipranavir/ritonavir)
Simeprevir (Olysio®), tablet 150 mg, once daily with food	NS3/4A protease inhibitor	Contraindicated in Child class C No change in renal impairment	Genotypes 1, 4, Low genetic barrier	Contraindicated with cyclosporine	Inhibitors or inducers of CYP3A4 (Antifungals: fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole; Antibiotics: clarithromycin, erythromycin, telithromycin; Dexamethasone; Cicapride; HIV drugs: cobicistat, efavirenz, delavirdine, etravirine, nevirapine, ritonavir and any HIV protease inhibitor)P-glycoprotein inducers
Daclatasvir(Daklinza®), tablet 60 mg, once daily	NS5A inhibitor	No change in liver or renal impairment	Genotypes 1,3,4, Low genetic barrier	No change	Strong inducers of CYP3A4 and/or P-glycoprotein (e.g., phenytoin, carbamazepine, oxcarbazepine, phenobarbital, rifampicin, rifabutin, rifapentine, dexamethasone, St John’s wort; HIV drugs: darunavir, lopinavir, etravirine)
Ledipasvir/Sofosbuvir/(Harvoni®), tablet 90/400 mg, once daily	NUC NS5B polymerase inhibitor + NS5A Inhibitor	No change in hepatic impairment Contraindicated in patients with GFR < 30 mL/min	Genotypes 1,3,4, High genetic barrier	No change	P-glycoprotein inducers, rosuvastatin, simeprevir
Paritaprevir/Ritonavir/Ombitasvir (Viekirax®), tablet 75/50/12.5 mg, x 2 once daily with food	Ritonavir boosted NS3/4A protease inhibitor/NS5A inhibitor	No safety and efficacy data in Child class B, Contraindicated in Child class C No change in renal dysfunction	Genotypes 1, 4, Genetic barrier depending on HCV genotype	Cyclosporine: 20% of pretreatment total daily dose; tacrolimus: 0.2 mg/72 h or 0.5 mg once weekly	P-glycoprotein inducers, gemfibrozil, lovastatin, simvastatin, oral midazolam, triazolam, pimozide, ethinyl estradiol-containing oral contraceptives, sildenafil for pulmonary hypertension
Dasabuvir (Exviera®), tablet 250 mg, every 12 h	Non-NUC NS5B polymerase inhibitor		Genotype 1, Low genetic barrier

NUC: Nucleos(t)ide analogue; CNI: Calcineurin inhibitor.