Higley C, Hsu CC, Smith C, Nadella S, Lalos AT. Safety and efficacy of sofosbuvir/velpatasvir/voxilaprevir in post-liver transplant patients with previous direct-acting antiviral failure: Six case reports. World J Hepatol 2020; 12(12): 1341-1348 [PMID: 33442459 DOI: 10.4254/wjh.v12.i12.1341]
Corresponding Author of This Article
Cory Higley, DO, Attending Doctor, Department of Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW PHC 5, Washington, DC 20007, United States. cory.higley@gunet.georgetown.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Dec 27, 2020; 12(12): 1341-1348 Published online Dec 27, 2020. doi: 10.4254/wjh.v12.i12.1341
Safety and efficacy of sofosbuvir/velpatasvir/voxilaprevir in post-liver transplant patients with previous direct-acting antiviral failure: Six case reports
Cory Higley, Christine C Hsu, Coleman Smith, Sandeep Nadella, Alexander T. Lalos
Cory Higley, Department of Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Christine C Hsu, Coleman Smith, Alexander T. Lalos, Transplant Institute, MedStar Georgetown University Hospital, Washington, DC 20007, United States
Sandeep Nadella, Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
Author contributions: Higley C collected and analyzed the data; Higley C and Nadella S wrote the manuscript; Hsu CC, Smith C, and Lalos AT designed the research study and edited the manuscript; Lalos AT is the guarantor of the article; and all authors issued final approval for the version to be submitted.
Informed consent statement: Informed consent or a substitute of consent was obtained from all patients prior to inclusion in the study.
Conflict-of-interest statement: Smith C has previously received research support from AbbVie, Gilead, Conatus, Allergen, and Genfit. Smith C and Lalos A have been on the speakers bureau for Gilead and AbbVie.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cory Higley, DO, Attending Doctor, Department of Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW PHC 5, Washington, DC 20007, United States. cory.higley@gunet.georgetown.edu
Received: July 10, 2020 Peer-review started: July 10, 2020 First decision: October 6, 2020 Revised: October 16, 2020 Accepted: October 30, 2020 Article in press: October 30, 2020 Published online: December 27, 2020
Abstract
BACKGROUND
Direct-acting antiviral (DAA) therapy regimens are highly effective at eliminating hepatitis C virus (HCV) infection but rates of sustained virologic response (SVR) are lower in patients with decompensated cirrhosis or hepatocellular carcinoma. Since many of these patients will be referred for liver transplant, they will require retreatment after transplantation. Sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) is recommended by guidelines as the preferred regimen to treat HCV in DAA-experienced patients following liver transplant however there is limited data.
CASE SUMMARY
We present the cases of six liver transplant recipients who had previous treatment failure with sofosbuvir-based DAA therapy prior to transplantation and who then received SOF/VEL/VOX after transplant.
CONCLUSION
This case series demonstrate the real-world efficacy and safety of SOF/VEL/VOX in the post liver transplant setting. Treatment was successful with all patients achieving SVR, it was well tolerated, and there were minimal drug-drug interactions with their immunosuppressants.
Core Tip: There have been limited reports published on the use of sofosb-uvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for the treatment of hepatitis C virus in post-liver transplant patients who had previous direct-acting antiviral failure prior to transplant. Herein, we present what we believe to be the largest case series of SOF/VEL/VOX use in these patients and highlight its efficacy and safety. More so, we discuss potential drug-drug interactions between SOF/VEL/VOX and common immunosuppression regimens.
