Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants
2021; Elsevier BV; Volume: 21; Issue: 11 Linguagem: Inglês
10.1111/ajt.16747
ISSN1600-6143
AutoresGaurav Gupta, Idris Yakubu, Yiran Zhang, Pamela Kimball, Le Kang, Kimberly Mitchell, Stephen C. Ijioma, Norman V. Carroll, Julie A. Patterson, Meagan Shinbashi, Dhiren Kumar, Irfan Moinuddin, Layla Kamal, Anne L. King, Chandra Bhati, Marlon F. Levy, Adrian Cotterell, Aamir Khan, Amit Sharma, Richard K. Sterling,
Tópico(s)Hepatitis B Virus Studies
ResumoAmerican Journal of TransplantationVolume 21, Issue 11 p. 3734-3742 BRIEF COMMUNICATION Outcomes of short-duration antiviral prophylaxis for hepatitis C positive donor kidney transplants Gaurav Gupta, Corresponding Author Gaurav Gupta gaurav.gupta@vcuhealth.org orcid.org/0000-0003-1919-1970 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Correspondence Gaurav Gupta, MCV Campus, 1200 E Marshall St, Richmond, VA 23298, USA. Email: gaurav.gupta@vcuhealth.orgSearch for more papers by this authorIdris Yakubu, Idris Yakubu Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorYiran Zhang, Yiran Zhang Global Health Economics & Outcomes Research, Indivior Inc., Richmond, Virginia, USASearch for more papers by this authorPamela Kimball, Pamela Kimball Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorLe Kang, Le Kang Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USASearch for more papers by this authorKimberly Mitchell, Kimberly Mitchell Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorStephen Ijioma, Stephen Ijioma Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorNorman Carroll, Norman Carroll Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorJulie Patterson, Julie Patterson Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorMeagan Shinbashi, Meagan Shinbashi Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorDhiren Kumar, Dhiren Kumar orcid.org/0000-0002-6816-9297 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorIrfan Moinuddin, Irfan Moinuddin orcid.org/0000-0002-0154-2261 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorLayla Kamal, Layla Kamal Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAnne King, Anne King Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorChandra Bhati, Chandra Bhati orcid.org/0000-0002-4333-5551 Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorMarlon Levy, Marlon Levy orcid.org/0000-0002-3320-0493 Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAdrian Cotterell, Adrian Cotterell Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAamir Khan, Aamir Khan Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAmit Sharma, Amit Sharma Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorRichard Sterling, Richard Sterling Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Section of Hepatology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this author Gaurav Gupta, Corresponding Author Gaurav Gupta gaurav.gupta@vcuhealth.org orcid.org/0000-0003-1919-1970 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Correspondence Gaurav Gupta, MCV Campus, 1200 E Marshall St, Richmond, VA 23298, USA. Email: gaurav.gupta@vcuhealth.orgSearch for more papers by this authorIdris Yakubu, Idris Yakubu Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorYiran Zhang, Yiran Zhang Global Health Economics & Outcomes Research, Indivior Inc., Richmond, Virginia, USASearch for more papers by this authorPamela Kimball, Pamela Kimball Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorLe Kang, Le Kang Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USASearch for more papers by this authorKimberly Mitchell, Kimberly Mitchell Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorStephen Ijioma, Stephen Ijioma Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorNorman Carroll, Norman Carroll Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorJulie Patterson, Julie Patterson Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USASearch for more papers by this authorMeagan Shinbashi, Meagan Shinbashi Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorDhiren Kumar, Dhiren Kumar orcid.org/0000-0002-6816-9297 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorIrfan Moinuddin, Irfan Moinuddin orcid.org/0000-0002-0154-2261 Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorLayla Kamal, Layla Kamal Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAnne King, Anne King Division of Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorChandra Bhati, Chandra Bhati orcid.org/0000-0002-4333-5551 Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorMarlon Levy, Marlon Levy orcid.org/0000-0002-3320-0493 Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAdrian Cotterell, Adrian Cotterell Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAamir Khan, Aamir Khan Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorAmit Sharma, Amit Sharma Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this authorRichard Sterling, Richard Sterling Division of Transplantation, Hume-Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Section of Hepatology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USASearch for more papers by this author First published: 01 July 2021 https://doi.org/10.1111/ajt.16747 Funding information: This study was partly supported by the VCU President Research Quest for Excellence (PeRQ) Fund. DAA medications for BK Group 1 were provided by VCU Health Pharmacy Services. DAA medications for 15 patients in the 4-day prophylaxis group were provided by Gilead Pharmaceuticals (CA, USA). Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Trials describing 4- to 12-week courses of direct-acting antiviral drugs (DAAs) to treat hepatitis C virus (HCV) transmission from infected donors to uninfected kidney transplant recipients (D+/R− transplants) may be limited in "real-world" application by costs and delayed access to DAAs. We previously reported HCV transmission of 13% among D+/R− transplants with 2- to 4-day pangenotypic sofosbuvir/velpatasvir (SOF/VEL) perioperative prophylaxis, where one patient with HCV transmission was a nonresponder to first-line full-course DAA. Here, we report new data with a 7-day prophylaxis protocol (N = 50), as well as cumulative treatment and outcome data on all HCV D+/R− transplants (N = 102). Overall, nine patients (9/102; 9%; 95% CI: 5%–16%) developed HCV transmission, with a significant decline noted in the 7-day group (2/50; 4%; 95% CI: 0%–13%) compared with 2- to 4-day prophylaxis (7/52; 13%; 95% CI: 5%–25%). All patients with HCV transmission achieved sustained virologic response post full-course therapy (including one nonresponder from initial trial). A 1:1 matched analysis (N = 102) with contemporary HCV D−/R− transplants (controls) showed that although the pretransplant wait time was significantly shorter for D+/R− compared with D−/R− (mean: 1.8 vs. 4.4 years; p < .001), there were no differences in infections, rejection, development of de novo donor-specific antibody, or transplant outcomes up to 6 months of transplant. Open Research DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request. Supporting Information Filename Description ajt16747-sup-0001-Appendix.docxWord document, 561.8 KB Supplementary Material Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume21, Issue11November 2021Pages 3734-3742 AST and ASTS members - please log in via your Society website for full journal access.AST Members >> ASTS Members >> RelatedInformation
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