Sofosbuvir and simeprevir combination therapy in the setting of liver transplantation and hemodialysis

Transpl Infect Dis. 2015 Apr;17(2):275-8. doi: 10.1111/tid.12348. Epub 2015 Jan 31.

Abstract

We report safety, tolerability, and 12-week sustained virologic response with half-standard dose sofosbuvir and standard-dose simeprevir combination therapy in a hepatitis C virus genotype 1a-infected liver transplant recipient on hemodialysis - uncharted territory for sofosbuvir-based therapy. The patient was a non-responder to prior treatment with pegylated interferon plus ribavirin. Sofosbuvir efficacy was maintained despite pill-splitting and administration of half-standard dose, 200 mg per day. No drug-drug interactions were noted with tacrolimus-based immunosuppression. Laboratory tests remained stable or improved during therapy. Our observation, if reproduced in a larger study, may lead to significant improvement in clinical outcomes and cost savings in this patient population.

Keywords: direct-acting antivirals; hemodialysis; hepatitis C virus; liver transplantation; simeprevir; sofosbuvir.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Drug Therapy, Combination
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Renal Dialysis
  • Simeprevir / therapeutic use*
  • Sofosbuvir / therapeutic use*
  • Transplant Recipients
  • Treatment Outcome
  • Viral Load

Substances

  • Antiviral Agents
  • Simeprevir
  • Sofosbuvir