Paritaprevir-ritonavir, ombitasvir and dasabuvir plus ribavirin to treat hepatitis C genotype 1 infection after liver transplantation: A single-center experience

Hepatitis C virus (HCV) infection is a disease with a significant worldwide impact. In Europe and the United States, chronic hepatitis C is the most common cause of chronic hepatic disease and the main indication for liver transplantation. Recurrent hepatitis C infection is universal among transplant recipients who have detectable viremia at the time of transplantation. Hepatitis C treatment was revolutionized with the introduction of safe, powerful direct action antivirals (DAA), which allow the use of multidrug combinations that can selectively inhibit the targets required for viral replication. One of these regimens combined paritarpevir [NS3/4A protease inhibitor], ombitasvir [NS5A inhibitor] and dasabuvir [NS5B polymerase inhibitor], plus ribavirin and was found to be highly effective (SVR rates of 97% in genotype 1). We report the results of a real-world clinical practice study in a single clinical unit in 22 liver graft recipients, transplanted due to cirrhosis caused by genotype 1 HCV with post-transplantation viral recurrence, who received ombitsavir combined with paritaprevir-ritonavir plus dasabuvir and ribavirin. We found an SVR rate at 12 weeks post-treatment of 100% and a remarkably low rate of adverse events. Conclusion: oral ombitasvir combined with ritonavir-paritaprevir plus dasabuvir and ribavirin for 24 weeks is a highly effective treatment for eliminating HCV in liver transplant recipients with genotype 1 and scant fibrosis, producing few serious adverse effects. Abbreviations: CBC: Complete Blood Count; CMP: Comprehensive Metabolic Panel; DAA: Direct Action Antivirals; DSV: Dasabuvir; HCV: Hepatitis C Virus; OBV: Ombitasvir; PTV: Paritaprevir; PEGIFN: Pegylated Interferon; r: Ritonavir; RBV: Ribavirin; SVR: Sustained Virologic Response