Safety and Efficacy of Direct-Acting Antivirals in the Treatment of Hepatitis C in Transplant Recipients

Authors

  • Elodie Bomfim Hyppolito Universidade Federal do Ceará – Faculdade de Medicina – Programa de Pós-Graduação em Saúde Pública – Fortaleza (CE) – Brazil | Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil | Universidade Federal do Ceará – Faculdade de Medicina – Departamento de Saúde Comunitária – Fortaleza (CE) – Brazil. https://orcid.org/0000-0002-6622-6585
  • Roberto da Justa Pires Neto Universidade Federal do Ceará – Faculdade de Medicina – Departamento de Saúde Comunitária – Fortaleza (CE) – Brazil. https://orcid.org/0000-0003-0291-9523
  • Larissa Peixoto Teixeira Universidade de Fortaleza – Fortaleza (CE) – Brazil. https://orcid.org/0009-0007-3645-8039
  • Lara Martins Sampaio Marques Universidade de Fortaleza – Fortaleza (CE) – Brazil. https://orcid.org/0000-0003-3005-167X
  • Vitória Bezerra de Alencar Universidade de Fortaleza – Fortaleza (CE) – Brazil. https://orcid.org/0000-0002-3137-5919
  • Karla Brandão Pereira Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0009-0005-1876-3641
  • Lívia Melo Carone Linhares Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0000-0001-7527-010X
  • Antônio Haroldo Araújo Filho Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0000-0003-2597-025X
  • Cyntia Ferreira Gomes Viana Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0000-0002-1102-7976
  • Tarciso Daniel dos Santos Rocha Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0009-0006-2912-0702
  • Clébia Azevedo de Lima Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0000-0002-7762-7149
  • Anderson Fuentes Ferreira Universidade Federal do Ceará – Faculdade de Medicina – Programa de Pós-Graduação em Saúde Pública – Fortaleza (CE) – Brazil. https://orcid.org/0000-0002-1816-9459
  • Alberto Novaes Ramos Júnior Universidade Federal do Ceará – Faculdade de Medicina – Departamento de Saúde Comunitária – Fortaleza (CE) – Brazil. https://orcid.org/0000-0001-7982-1757
  • José Huygens Parente Garcia Universidade Federal do Ceará – Departamento de Cirurgia – Serviço de Transplante de Fígado – Fortaleza (CE) – Brazil. https://orcid.org/0000-0003-4401-137X

Keywords:

Hepatitis C, Liver Transplantation, Biological Treatment, Direct-Acting Antivirals

Abstract

Objectives:  To perform a comparative analysis, evaluating the efficacy and safety profiles discerningly in a cohort of liver transplant recipients and non-liver transplant recipients infected with hepatitis C and treated with direct-acting antivirals (DAA). Methods:  This study is a real-life retrospective, observational analysis of individuals with chronic hepatitis C who were treated with DAA. During this period, 990 patients diagnosed with hepatitis C received DAA therapy, 165 of whom had undergone liver transplantation. Exclusion criteria included HIV-positive patients and those without a sustained virologic response (SVR) assessment. Results:  The SVR was 95.8 and 95.6% in liver transplant recipients and nonrecipients, respectively (p = 0.94). The majority of patients were treated with sofosbuvir (SOF) in combination with daclatasvir, simeprevir, and ledipasvir. Ribavirin (RBV) was co-administered to 43.2% of patients, resulting in no improvement in SVR and an increase in adverse events. Treatment of genotype 2 patients with SOF and RBV and genotype 3 patients with SOF, interferon, and RBV for only 12 weeks showed suboptimal efficacy (89.5 and 83.3%), respectively. Conclusion:  The treatment of hepatitis C with DAA is as effective and safe in liver transplant patients as in non-liver transplant patients, and the prescription of RBV is inadvisable due to the increase in serious adverse events without improvement in SVR.

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Published

2025-03-17

How to Cite

1.
Hyppolito EB, Pires Neto R da J, Teixeira LP, Marques LMS, Alencar VB de, Pereira KB, et al. Safety and Efficacy of Direct-Acting Antivirals in the Treatment of Hepatitis C in Transplant Recipients. bjt [Internet]. 2025 Mar. 17 [cited 2025 Mar. 30];28. Available from: https://bjt.emnuvens.com.br/revista/article/view/662

Issue

Vol. 28 (2025)

Section

Original Paper

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Copyright (c) 2025 Elodie Bomfim Hyppolito, Roberto da Justa Pires Neto, Larissa Peixoto Teixeira , Lara Martins Sampaio Marques, Vitória Bezerra de Alencar, Karla Brandão Pereira, Lívia Melo Carone Linhares, Antônio Haroldo Araújo Filho, Cyntia Ferreira Gomes Viana, Tarciso Daniel dos Santos Rocha, Clébia Azevedo de Lima, Anderson Fuentes Ferreira, Alberto Novaes Ramos Júnior, José Huygens Parente Garcia

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