Olysio and Sovaldi Post Transplant

[hrsepwrguy]

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Hepatitis C Management in Special Populations

    Author: Mark S. Sulkowski, MD (More Info)
    Editors In Chief: Nezam H. Afdhal, MD, FRCPI; Stefan Zeuzem, MD
    Last Reviewed: 2/26/14 (What's New)

Summary

    Sofosbuvir and simeprevir are now recommended in the 2014 AASLD/IDSA guidelines (Management Guidelines)[AASLD-IDSA HCV] as part of preferred or alternative regimens for the treatment of recurrent HCV infection in posttransplanted patients (Table 11)
    The recommended standard of care for liver transplant recipients is treatment of confirmed recurrent liver disease, based either on persistent, unexplained elevated ALT levels or on histologically confirmed fibrosis once rejection, biliary obstruction, and vascular damage have been ruled out (Table 12)[Ghany 2009; Ponziani 2011]

https://www.inpractice.com/Textbooks/Hepatology/ch9_Hep_C_Management_in_Special_Populations/Chapter-Pages/Page-5/Subpage-1.aspx

[Semperfical]

I am 2 1/2 years post transplant and have been on Olysio /Solvaldi regimen for 12 weeks since 1/6. So far labs have been normal undetected after wk4.

[nan535]

Thank you for your kind wishes.  He has had to reduce the ribavirin to 200 mg daily due to weekly episodes of HE (explained on another thread). But even with the lower dose, his viral load has still been <43 since week 2.  All of his labwork is showing great improvement already.  Hopefully, they will be able to up the ribavirin soon.

I can certainly see why the guidelines recommend he be under care of a highly experienced HCV provider.

Thanks
Nan

[hepcandme]

Good luck to you and your husband Nan! Keeping you in my thoughts!

[nan535]

Unfortunately, my post-transplant husband is not eligible for this treatment since he has symptoms of decompensated cirrhosis - portal hypertension and hepatic encephalopathy  (CTP Class B).

See  Page 65  http://www.hcvguidelines.org/fullreport

"The following regimens are NOT recommended for patients with decompensated cirrhosis (moderate or severe hepatic impairment; CTP Class B or C)
Any IFN-based therapy
Monotherapy with PEF, RBV, or a DAA
Telaprevir - Boceprevir - or Simeprevir based regimens"

Instead they recommend Sovaldi+ Ribavrin for 24 weeks under the care of a highly experienced HCV provider preferably at a transplant center.

This is the treatment my husband is on now for 6 1/2 weeks.

Nan
Nan

[ppmguy]

       this will get you there


         hcvguidelines.org/full-report-view