Sofosbuvir plus glecaprevir/pibrentasvir as salvage therapy after liver transplantation in NS5A inhibitor-experienced patients. A case series.

Ignacio García-Juárez, Carlos Alonzo-García, Alan G Contreras, Fernanda Romero-Hernández, Maximiliano Servín-Rojas, Alfonso Fernández-Ramírez, Isaac Ruiz

Journal: Gaceta medica de Mexico 2023;159(4):331-336

PMID: 37699225

Abstract

BACKGROUND

Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals achieves a sustained virologic response rate higher than 95%. However, virologic failure remains a clinical challenge, and data on retreatment are limited, especially in special populations such as liver transplant (LT) recipients.

OBJECTIVES

This study evaluated the sofosbuvir plus glecaprevir-pibrentasvir (GLE/PIB) regimen in LT recipients who had failed to a nonstructural protein 5A (NS5A) inhibitor-based regimen.

MATERIAL AND METHODS

Retrospective study of 111 liver transplant recipients between January 2018 and December 2020; 18 patients presented with HCV recurrent infection after LT, out of whom three had a history of at least one NS5A inhibitor-based regimen. Salvage therapy with sofosbuvir plus GLE/PIB was started for 12 weeks; baseline characteristics and outcomes were recorded.

RESULTS

All three patients (100%) achieved an undetectable HCV viral load 12 weeks after treatment completion. No serious adverse events were observed.

CONCLUSION

In our series, sofosbuvir plus GLE/PIB for 12 weeks is an effective and safe salvage therapy after LT in patients previously treated with NS5A inhibitors.

Copyright: © 2023 Permanyer.

Address: Gastroenterology Department and Liver Transplant Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.; Deparment of Experimental Surgery. Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.; Service d'Hépatologie et de Transplantation Hépatique. Centre Hospitalier de l'Université de Montréal. Montréal, Canada.; Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor, Université Paris-Est. Créteil, France.
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