Telaprevir in treatment of recurrent hepatitis C infection in liver transplant recipients

Satheesh Nair, Bradford Waters

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: Recurrent hepatitis C infection leads to accelerated graft loss in liver transplant recipients. Telaprevir offers a higher chance of cure in these patients. We sought to assess the effectiveness of telaprevir in treatment of hepatitis C in liver transplant recipients. Materials and Methods: We report a series of 17 patients who received telaprevir for recurrent hepatitis C virus infection. These patients were previous treatment failures including 10 null responders. All patients received pegylated interferon alpha 2a (180 μg/wk) and ribavirin (800 mg/d) for 1 year and telaprevir 750 mg every 8 hours for 12 weeks. The immunosuppressive regimen was not changed during therapy, but the dosages were modified based on serum levels of the drugs. Results: In an intention-to-treat analysis, the overall sustained virologic response 12 was 58%, with a relapse rate of 24%. Nine patients (52%) achieved extended rapid virologic response. Seven patients (77%) with extended rapid virologic response achieved sustained virologic response 12. Four patients (40%), who were previous null responders to interferon and ribavirin also achieved sustained virologic response 12. Anemia and ribavirin dosage reduction were common. Severe thrombocytopenia was seen in 2 patients resulting in discontinuation of therapy. A tacrolimus-based immunosuppressive regimen could be continued with close monitoring. During the initial 4 weeks of therapy, there were wide fluctuations in tacrolimus levels. However, after 4 weeks, tacrolimus could be dosed weekly maintaining a trough level of 3 to 10 ng/mL. Conclusions: Telaprevir can be used effectively in liver transplant recipients receiving tacrolimusbased immunosuppression. Sustained virologic response 12 can be achieved in a significant number of these "difficult-to-treat" patients.

Original languageEnglish (US)
Pages (from-to)117-122
Number of pages6
JournalExperimental and Clinical Transplantation
Volume12
Issue number2
DOIs
StatePublished - Jan 1 2014

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Hepatitis C
Liver
Infection
Ribavirin
Tacrolimus
Therapeutics
Immunosuppressive Agents
Transplant Recipients
telaprevir
Intention to Treat Analysis
Virus Diseases
Treatment Failure
Hepacivirus
Thrombocytopenia
Immunosuppression
Interferons
Anemia
Transplants
Recurrence
Sustained Virologic Response

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Telaprevir in treatment of recurrent hepatitis C infection in liver transplant recipients. / Nair, Satheesh; Waters, Bradford.

In: Experimental and Clinical Transplantation, Vol. 12, No. 2, 01.01.2014, p. 117-122.

Research output: Contribution to journalArticle

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