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dc.contributor.authorLin, Ming V.en_US
dc.contributor.authorSise, Meghan E.en_US
dc.contributor.authorPavlakis, Marthaen_US
dc.contributor.authorAmundsen, Beth M.en_US
dc.contributor.authorChute, Donalden_US
dc.contributor.authorRutherford, Anna E.en_US
dc.contributor.authorChung, Raymond T.en_US
dc.contributor.authorCurry, Michael P.en_US
dc.contributor.authorHanifi, Jasmine M.en_US
dc.contributor.authorGabardi, Steveen_US
dc.contributor.authorChandraker, Anilen_US
dc.contributor.authorHeher, Eliot C.en_US
dc.contributor.authorElias, Nahelen_US
dc.contributor.authorRiella, Leonardo V.en_US
dc.date.accessioned2016-10-11T20:27:05Z
dc.date.issued2016en_US
dc.identifier.citationLin, M. V., M. E. Sise, M. Pavlakis, B. M. Amundsen, D. Chute, A. E. Rutherford, R. T. Chung, et al. 2016. “Efficacy and Safety of Direct Acting Antivirals in Kidney Transplant Recipients with Chronic Hepatitis C Virus Infection.” PLoS ONE 11 (7): e0158431. doi:10.1371/journal.pone.0158431. http://dx.doi.org/10.1371/journal.pone.0158431.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:29002586
dc.description.abstractThe prevalence of Hepatitis C Virus (HCV) infection is significantly higher in patients with end-stage renal disease compared to the general population and poses important clinical challenges in patients who undergo kidney transplantation. Historically, interferon-based treatment options have been limited by low rates of efficacy and significant side effects, including risk of precipitating rejection. Limited data exist on the use of all-oral, interferon-free direct-acting antiviral (DAA) therapies in kidney transplant recipients. In this study, we performed a retrospective chart review with prospective clinical follow-up of post-kidney transplant patients treated with DAA therapies at three major hospitals in Boston, MA. A total of 24 kidney recipients with HCV infection received all-oral DAA therapy post-transplant. Patients were predominantly male (79%) with a median age of 60 years (range 34–70 years), median creatinine of 1.2 mg/dL (0.66–1.76), and 42% had advanced fibrosis or cirrhosis. The majority had HCV genotype 1a infection (58%). All patients received full-dose sofosbuvir; it was paired with simeprevir (9 patients without and 3 patients with ribavirin), ledipasvir (7 patients without and 1 patient with ribavirin) or ribavirin alone (4 patients). The overall sustained virologic response (SVR12) was 91% (21 out of 23 patients). One patient achieved SVR4 but demised prior to SVR12 check point due to treatment unrelated cause. Two treatment failures were successfully retreated with alternative DAA regimens and achieved SVR. Both initials failures occurred in patients with advanced fibrosis or cirrhosis, with genotype 1a infection, and prior HCV treatment failure. Adverse events were reported in 11 patients (46%) and were managed clinically without discontinuation of therapy. Calcineurin inhibitor trough levels did not significantly change during therapy. In this multi-center series of patients, all-oral DAA therapy appears to be safe and effective in post-kidney transplant patients with chronic HCV infection.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0158431en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945034/pdf/en
dash.licenseLAAen_US
dc.subjectBiology and life sciencesen
dc.subjectOrganismsen
dc.subjectVirusesen
dc.subjectRNA virusesen
dc.subjectFlavivirusesen
dc.subjectHepacivirusen
dc.subjectHepatitis C virusen
dc.subjectMicrobiologyen
dc.subjectMedical microbiologyen
dc.subjectMicrobial pathogensen
dc.subjectViral pathogensen
dc.subjectMedicine and health sciencesen
dc.subjectPathology and laboratory medicineen
dc.subjectPathogensen
dc.subjectHepatitis virusesen
dc.subjectMedicine and Health Sciencesen
dc.subjectSurgical and Invasive Medical Proceduresen
dc.subjectTransplantationen
dc.subjectOrgan Transplantationen
dc.subjectRenal Transplantationen
dc.subjectUrinary System Proceduresen
dc.subjectDigestive System Proceduresen
dc.subjectLiver Transplantationen
dc.subjectBiology and Life Sciencesen
dc.subjectAnatomyen
dc.subjectRenal Systemen
dc.subjectKidneysen
dc.subjectClinical Research Designen
dc.subjectAdverse Eventsen
dc.subjectVirologyen
dc.subjectViral Transmission and Infectionen
dc.subjectViral Loaden
dc.subjectDiagnostic Medicineen
dc.subjectSigns and Symptomsen
dc.subjectProteinuriaen
dc.subjectPathology and Laboratory Medicineen
dc.subjectPharmacologyen
dc.subjectDrugsen
dc.subjectAntimicrobialsen
dc.subjectAntiviralsen
dc.subjectMicrobial Controlen
dc.titleEfficacy and Safety of Direct Acting Antivirals in Kidney Transplant Recipients with Chronic Hepatitis C Virus Infectionen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorLin, Ming V.en_US
dc.date.available2016-10-11T20:27:05Z
dc.identifier.doi10.1371/journal.pone.0158431*
dash.authorsorderedfalse
dash.contributor.affiliatedSise, Meghan
dash.contributor.affiliatedPavlakis, Martha
dash.contributor.affiliatedAmundsen, Beth M.
dash.contributor.affiliatedHanifi, Jasmine
dash.contributor.affiliatedRutherford, Anna
dash.contributor.affiliatedChandraker, Anil
dash.contributor.affiliatedChung, Raymond
dash.contributor.affiliatedCurry, Michael
dash.contributor.affiliatedHeher, Eliot
dash.contributor.affiliatedRiella, Leonardo
dash.contributor.affiliatedElias, Nahel
dash.contributor.affiliatedLin, Ming V.


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