Efficacy and Tolerability of Pegylated Interferon and Ribavirin in Combination with Simeprevir to Treat Hepatitis C Virus Infections After Living Donor Liver Transplantation

Pegylated interferon and ribavirin plus simeprevir therapy (simeprevir-based triple therapy) has been recently introduced, providing excellent results for nontransplant patients with hepatitis C virus (HCV) infection. However, there are limited data available on its effect on liver transplant recipients. In the present study, we evaluated the efficacy and tolerability of simeprevir-based triple therapy in liver transplant recipients. We treated 9 liver transplant recipients for genotype 1b HCV reinfection with simeprevir-based triple therapy. The efficacy and adverse effects were evaluated until 24 weeks after therapy. All recipients continued immunosuppressive therapy at the same dose as that before therapy induction. Seven of the 9 recipients (77.8%) achieved sustained virological response at 24 weeks. Two recipients (22.2%) experienced viral breakthrough (BT) at 12 and 16 weeks; NS3 HCV mutations conferring resistance to simeprevir were detected in both these patients after BT. Anemia was the most common adverse effect, requiring ribavirin dose reduction and blood transfusion. However, all recipients, except those with BT, completed the 24-week therapy. No recipient experienced cellular rejection during therapy. In conclusion, simeprevir-based triple therapy exhibited high efficacy and tolerability in liver transplant recipients with genotype 1b HCV reinfection.