People waiting for a kidney transplant may do well to receive such an organ from a donor with hepatitis C virus (HCV), MedPage Today reports. A recent small study found that doing so and then treating the recipient with direct-acting antivirals (DAAs) was safe and effective.
Publishing their findings in the Annals of Internal Medicine, researchers conducted a study of 20 HCV-negative individuals who were awaiting a kidney transplant. They received kidneys from 15 different HCV-positive donors. Ten of the participants were enrolled in the THINKER-1 study, and the other 10 were enrolled in the EXPANDER study.
After they received their kidneys, most of the participants were treated with 12 weeks of Zepatier. Three of the participants had hep C with mutations associated with resistance to NS5A inhibitor DAAs, so they received 16 weeks of Zepatier plus ribavirin according to protocol. All participants were treated with standard immunosuppression therapy to prevent rejection of their new organ.
All participants achieved a sustained virologic response 12 weeks after completing DAA therapy (SVR12, considered a cure of HCV).
None of the participants experienced serious adverse health events associated with hep C or with treatment of the virus. However, two of them were readmitted into the hospital within a month of their transplant operation. No one experienced organ rejection. Five participants experienced transient elevations of their amino-transferase levels, which can be an indication of compromised liver health.
The study authors compared the results of lab tests among the participants with test results from a group of matched HCV-negative kidney recipients. Six months post-surgery, the HCV-positive and the HCV-negative individuals had respective eGFR results (an indication of kidney function) of 67.5 and 66.2 milliliters per minute per 1.73 meters squared. Twelve months post-surgery, the corresponding test results were a respective 72.8 and 67.2 ml/min/1.73 m2. For each pair of results, the differences were not statistically significant, meaning they could have been driven by chance.
As for creatinine levels (another indication of kidney health), six months post-surgery the results for both HCV-positive and -negative individuals were a respective 1.2 and 1.2 milligrams per deciliter. Twelve months post-surgery the results were a respective 1.1 and 1.1 mg/dl.
The study is limited by its small size and the fact that it was conducted at one location, suggesting that other groups of patients or clinics with different treatment protocols may see different results.
To read a press release about the study, click here.
To read the study abstract, click here.
To read the MedPage Today article, click here.