A safety and efficacy analysis of direct-antiviral therapy in patients with chronic hepatitis C after renal transplantation

Background: To explore the safety and efficacy of direct antiviral therapy in patients with hepatitis C virus (HCV) infection after renal transplantation. Methods: We retrospectively reviewed the medical information of 15 cases of HCV+ patients treated with direct antiviral therapy after renal transplantation in our center. The effectiveness of direct antiviral therapy was evaluated by analyzing the HCV-RNA levels of patients at 1, 4, 12, 24, and 48 weeks before and after antiviral therapy. In addition, parameters including the rejection rate, the blood concentration of anti-rejection drugs, liver function level [alanine aminotransferase (ALT), aspartate transaminase (AST)], estimated glomerular filtration rate (eGFR) and serum creatinine (CREA) levels were used to assess its safety. Results: A total of 15 patients were enrolled in the study. All patients turned HCV-RNA negative after 12 weeks of direct-antiviral therapy; the serological test of all patients demonstrated an 100% response rate in rapid virological response (RVR) (15/15), 12-week sustained virological response (SVR12), and 24-week sustained virological response (SVR24). In addition, compared to pre-treatment, the liver function within 12, 24, and 48 weeks after treatment was significantly improved. Moreover, eGFR, CREA, and anti-rejection drug concentration remained stable while acute rejection reaction and other obvious side effects were not observed throughout the treatment period. Conclusions: The direct antiviral therapy was well-tolerated and effective for patients with chronic hepatitis C after renal transplantation.