Treatment efficacy and tolerability of Sofosbuvir and Ribavirin for chronic hepatitis C infection in post renal transplant patients – A retrospective single centre study

AimTo study the efficacy and tolerability of sofosbuvir and ribavirin in post renal transplant patients with chronic hepatitis C infection.MethodsData of 20 hepatitis C positive patients who had a negative viral load prior to renal transplant were analysed. They were given treatment with sofosbuvir 400 mg/day and dose adjusted ribavirin for 12 weeks, when they were found to have viraemia after transplant. Viral load was monitored at 4 weeks, 16 weeks and 24 weeks after initiation of therapy.Results12 patients had genotype 1, 6 patients had genotype 3 and only 1 patient had genotype 4. 1 patient had mixed genotype infection. The median viral load was 3,394,705 IU/ml. Virological response was assessed at 4 weeks, 16 weeks and 24 weeks after treatment initiation. Rapid virological response (RVR) was seen in 19 patients (95%). Virological response at 4 weeks after treatment completion (SVR 4) was seen in 19 (95%) patients. Data were available for 13 patients who completed follow-up for 12 weeks after treatment completion. The remaining patients discontinued the drugs due to financial reasons. Sustained virological response at 12 weeks after treatment completion (SVR 12) was seen in 10 out of the 13 patients (76.9%). 3 patients did not attain SVR 12 and were regarded as treatment failure. The drugs were well tolerated in the majority. 1 patient required erythropoietin temporarily after ribavirin therapy.ConclusionSofosbuvir and ribavirin showed a good efficacy and tolerability when used in renal transplant recipients. However, the genotype, nature of underlying liver disease, duration of therapy play an important factor in deciding the response to therapy.