Effectiveness of ledipasvir/sofosbuvir with/without ribavarin in liver transplant recipients with hepatitis C

Sammy Saab, Justin Rheem, Melissa A. Jimenez, Tiffany M. Fong, Michelle H. Mai, Caterina A. Kachadoorian, Negin L. Esmailzadeh, Sherona N. Bau, Susan Kang, Samantha D. Ramirez, Jonathan Grotts, Gina Choi, Francisco A. Durazo, Mohammed M. El-Kabany, Steven Huy B. Han, Ronald W. Busuttil

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12 Scopus citations


Background and Aims: Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality. Methods: We retrospectively evaluated the safety and efficacy of ledipas-vir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C. Results: Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/ sofosbuvirwith and without ribavirin for 12 or 24 weeks. The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months. The mean (± SD) age of the cohort was 63 (±8.6) years old. Most recipients were male (70%). Baseline alanine transaminase, total bilirubin, and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126) mg/dL, 0.8 (±1.3) U/L, and 8,010,421.9 (±12,420,985) IU/mL, respectively. Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects, with 4 of those being anemia complications. No recipient discontin-ued the ledipasvir/sofosbuvir. Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy, and all recipients had complete viral suppression at the end of therapy. The sustained viral response at 12 weeks after com-pletion of therapy was 94%. Conclusion: Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT. Anemia is not uncommon in LT recipients receiving ribavirin.

Original languageEnglish (US)
Pages (from-to)101-108
Number of pages8
JournalJournal of Clinical and Translational Hepatology
Issue number2
StatePublished - 2017


  • Direct-acting agents
  • Hepatitis C
  • Immunosuppressant
  • Liver transplantation
  • Sustained viral response

ASJC Scopus subject areas

  • Hepatology


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