Hope for Transplant Patients

Jordon J. Feld, MD, MPH, FAASLD, reported important findings providing hope for transplant patients when opting to receive organs from a hepatitis C infected donor.

A recent study showed when non-hepatitis C infected transplant patients received a transplant with hepatitis C infected organs, a combination treatment with ezetimibe and direct-acting antiviral therapy, either prevented or rapidly cured hepatitis C.

The study included hepatitis C infected organs for 20 transplant recipients needing either lung, heart, kidney, or kidney-pancreas organs.

Combination Treatment

The study tested the possibility of preventing hepatitis C infection in transplant recipients who were given a combination treatment using Mavyret (glecaprevir/pibrentasvir 300/120mg) with ezetimibe 10 mg, 6 to 12 hours before transplantation and then taking the combination treatment daily for 1-week post-transplant.

Dr. Feld explained, “Ezetimibe is a cholesterol-lowering drug that is approved and quite safe, but also happens to be a ligand … for one of the entry factors that hepatitis C uses to enter hepatocytes (liver cells).

Study Conclusion

In the study, of the 20 transplant patients who received hepatitis C infected organs, for 13 patients, four developed quantifiable hepatitis C virus detected, the combination treatment provided showed hepatitis C declined rapidly and was non-detected by day 4.

Of six other patients, hepatitis C was detectable but unquantifiable at day 1 of post-transplant but with combination treatment provided, hepatitis C was undetected by day 2 in 5 of the patients and by day 4 in one patient.

For all transplant recipients in the study, the hepatitis C virus declined rapidly and was non-detected by day 4. Dr. Feld also reported no relapses to date with follow-up ranging up to 12.1 weeks.

The study concluded the combination treatment was well-tolerated with no serious adverse effects related to treatment. All patients showed non-detected for hepatitis C infection.

The Liver Meeting is made up of medical professionals associated with the AASLD (American Association for the Study of Liver Disease).

Reference: Feld JJ. Abstract 0038. Presented at: The Liver Meeting; Nov 7-12, 2019; Boston. Healio; Combination therapy prevents HCV infection in non-viremic organ recipients/Nov 10, 2019/Jordon J. Feld.

Disclosure: Feld reports receiving grant or research support, and serving as a consultant for Abbott, AbbVie, Enanta, Gilead, Janssen, Merck, and Roche.

This entry was originally published in Life Beyond Hep C, and is reprinted with permission.