Download PDF
Semin Liver Dis 2014; 34(01): 108-112
DOI: 10.1055/s-0034-1371084
Diagnostic Problems in Hepatology
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Case Report of Successful Treatment of Fibrosing Cholestatic Hepatitis C with Sofosbuvir and Ribavirin after Liver Transplantation

Brian Kim
1   The Recanati/Miller Transplantation Institute, Mount Sinai Health System, New York, New York
,
Anshu Trivedi
2   The Lillian and Henry M. Stratton – Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
,
Swan N. Thung
2   The Lillian and Henry M. Stratton – Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
,
Priya Grewal
1   The Recanati/Miller Transplantation Institute, Mount Sinai Health System, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
29 April 2014 (online)

   Permissions and Reprints

Abstract

Fibrosing cholestatic hepatitis is an unusual complication of hepatitis C virus (HCV) recurrence after liver transplant. Fibrosing cholestatic hepatitis is marked by aggressive progression of cholestasis and fibrosis, leading to accelerated graft loss and/or death. Sofosbuvir (GS-7977) is an oral nucleotide analogue inhibitor of HCV polymerase activity. It is a second-generation, direct-acting, antiviral for the treatment of HCV infection. This case illustrates a patient with recurrent HCV with fibrosing cholestatic hepatitis, who was successfully treated with a combination of sofosbuvir and ribavirin with normalization of liver enzyme activities and resolution of HCV-related symptoms. The favorable side effect profile and the lack of drug–drug interaction with immunosuppressive medications make the combination of sofosbuvir and ribavirin a promising regimen for severe HCV recurrence.

Keywords

hepatitis C virus - fibrosing cholestatic hepatitis - cholestatic variant of hepatitis C - liver transplant - sofosbuvir - ribavirin
 

  • References

  • 1 United Network for Organ Sharing. Transplant trends. Available at: http://www.unos.org/ . Accessed November 1, 2013
    PubMedGoogle Scholar
  • 2 Garcia-Retortillo M, Forns X, Feliu A , et al. Hepatitis C virus kinetics during and immediately after liver transplantation. Hepatology 2002; 35 (3) 680-687
    CrossrefPubMedGoogle Scholar
  • 3 Gane EJ, Portmann BC, Naoumov NV , et al. Long-term outcome of hepatitis C infection after liver transplantation. N Engl J Med 1996; 334 (13) 815-820
    CrossrefPubMedGoogle Scholar
  • 4 Berenguer M, Prieto M, Rayón JM , et al. Natural history of clinically compensated hepatitis C virus-related graft cirrhosis after liver transplantation. Hepatology 2000; 32 (4 Pt 1) 852-858
    CrossrefPubMedGoogle Scholar
  • 5 Cimsit B, Assis D, Caldwell C , et al. Successful treatment of fibrosing cholestatic hepatitis after liver transplantation. Transplant Proc 2011; 43 (3) 905-908
    CrossrefPubMedGoogle Scholar
  • 6 Satapathy SK, Sclair S, Fiel MI, Del Rio Martin J, Schiano T. Clinical characterization of patients developing histologically-proven fibrosing cholestatic hepatitis C post-liver transplantation. Hepatol Res 2011; 41 (4) 328-339
    CrossrefPubMedGoogle Scholar
  • 7 Narang TK, Ahrens W, Russo MW. Post-liver transplant cholestatic hepatitis C: a systematic review of clinical and pathological findings and application of consensus criteria. Liver Transpl 2010; 16 (11) 1228-1235
    CrossrefPubMedGoogle Scholar
  • 8 Gopal DV, Rosen HR. Duration of antiviral therapy for cholestatic HCV recurrence may need to be indefinite. Liver Transpl 2003; 9 (4) 348-353
    CrossrefPubMedGoogle Scholar
  • 9 Gane EJ, Stedman CA, Hyland RH , et al. Nucleotide polymerase inhibitor sofosbuvir plus ribavirin for hepatitis C. N Engl J Med 2013; 368 (1) 34-44
    CrossrefPubMedGoogle Scholar
  • 10 Osinusi A, Meissner EG, Lee YJ , et al. Sofosbuvir and ribavirin for hepatitis C genotype 1 in patients with unfavorable treatment characteristics: a randomized clinical trial. JAMA 2013; 310 (8) 804-811
    CrossrefPubMedGoogle Scholar
  • 11 Guillouche P, Féray C. Systematic review: anti-viral therapy of recurrent hepatitis C after liver transplantation. Aliment Pharmacol Ther 2011; 33 (2) 163-174
    CrossrefPubMedGoogle Scholar
  • 12 Levitsky J, Fiel MI, Norvell JP , et al. Risk for immune-mediated graft dysfunction in liver transplant recipients with recurrent HCV infection treated with pegylated interferon. Gastroenterology 2012; 142 (5) 1132-1139 , e1
    CrossrefPubMedGoogle Scholar
  • 13 Werner CR, Egetemeyr DP, Lauer UM , et al. Telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: a 12-week pilot study providing safety and efficacy data. Liver Transpl 2012; 18 (12) 1464-1470
    CrossrefPubMedGoogle Scholar
  • 14 Al Nahdi N, Ford JA, Greanya ED , et al. First successful treatment of post-liver transplant hepatitis C fibrosing cholestatic hepatitis with boceprevir, peginterferon and ribavirin in a pre-transplant null responder. Ann Hepatol 2013; 12 (1) 156-160
    PubMedGoogle Scholar
  • 15 Garg V, van Heeswijk R, Lee JE, Alves K, Nadkarni P, Luo X. Effect of telaprevir on the pharmacokinetics of cyclosporine and tacrolimus. Hepatology 2011; 54 (1) 20-27
    CrossrefPubMedGoogle Scholar
  • 16 Hulskotte E, Gupta S, Xuan F , et al. Pharmacokinetic interaction between the hepatitis C virus protease inhibitor boceprevir and cyclosporine and tacrolimus in healthy volunteers. Hepatology 2012; 56 (5) 1622-1630
    CrossrefPubMedGoogle Scholar
  • 17 Charlton MR, Gane EJ, Manns MP , et al. Sofosbuvir and Ribavirin for the treatment of established recurrent hepatitis C infection after liver transplantation: preliminary results of a prospective, multicenter study. Paper presented at: 64th Annual Meeting of the American Association for the Study of Liver Diseases; November 1–5, 2013; Washington, DC
    PubMedGoogle Scholar