C型肝炎に対する肝移植後長期経過症例に対する経口抗ウイルス薬療法の経験

抄録

Liver cirrhosis resulting from the recurrence of hepatitis in patients with hepatitis C virus (HCV) is the major cause of graft loss after liver transplantation (LT). The effectiveness of treatment by direct-acting antiviral agents (DAAs) against HCV has been reported in LT patients. We report our experiences of anti-HCV therapy using DAAs in long-term HCV recipients. Five patients treated with DAAs were included in this study. Two patients were treated with pegylated-interferon (peg-IFN), ribavirin (RBV), and simeprevir (SMV), and three were with daclatasvir (DCV) and asunaprevir (ASV). All five had been previously treated with interferon (IFN) or peg-IFN with RBV after LT. Four of them discontinued antiviral therapy because of heart failure, retinal detachment, cellulitis, or diabetes mellitus. HCV reappearance was experienced after in the remaining patient who continued the therapy. In all patients, the levels of serum HCV-ribo nucleic acid were decreased to the under-detection level within 15 weeks; sustained virological response 24 weeks after treatment (SVR24) was then achieved. HCV could be eradicated with DAAs therapy even in long-term LT patients with failed IFN.