Elbasvir/Grazoprevir with or without Sofosbuvir for Patients with
Chronic Hepatitis C Virus Infection Post Solid Organ Transplantation
Abstract
Background: A critical challenge in HCV therapy is managing patients who
undergo solid organ transplantation. Elbasvir/grazoprevir, a combination
of NS5A inhibitor and NS3/4A protease inhibitor, is considered a
first-line treatment for chronic HCV infection. Elbasvir/grazoprevir is
a newly approved treatment administered as a fixed-dose combination of
NS5A inhibitor and NS3/4A protease inhibitor. It has been widely
explored in patients with HCV GT 1 and 4 infections, and the combination
is recommended for HCV treatment by the American Association of the
study of liver disease. However, to date, clinical experience with
grazoprevir/elbasvir in the post-transplant setting is limited. In this
retrospective observational study, we aimed to assess the safety and
effectiveness of elbasvir and grazoprevir in a real-world, difficult to
treat, post solid organ transplant setting. Material and Methods: The
study involved evaluation of the patients with HCV infection post solid
organ transplantation and administered elbasvir/grazoprevir with/without
sofosbuvir in retrospective manner. Results: Forty-six patients were
enrolled in the study. Of those, 27 (58.69%) were men; 17 (37%) had
genotype 1 and 22 (47.8%) had genotype 4 HCV infections, and 30
(65.2%) were treatment experienced. The intention-to-treat analysis
revealed that 45 (97%) achieved SVR12 and 44 (95%) achieved SVR24. No
treatment-related adverse effects were identified. Conclusion:
elbasvir/grazoprevir is safe and effective for treating patients with
HCV infection post solid organ transplantation, which is on the most
difficult to treat population, at reduced cost in comparison to other
available direct acting antiviral.