Faculty Collaboration Database

Impact of Sustained Viral Response With Direct-Acting Agents on Glycemic Control and Renal Function in Hepatitis C Liver Transplant Recipients. Exp Clin Transplant 2018 Aug;16(4):419-424

Date

08/01/2018

Pubmed ID

30060729

DOI

10.6002/ect.2018.0088

Scopus ID

2-s2.0-85057936601 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVES: The impact of achieving a sustained viral response on extrahepatic manifestations after liver transplant is unclear. In this study, our aim was to evaluate whether sustained viral responses in hepatitis C-positive liver transplant recipients can lead to improved nonhepatic outcomes.

MATERIALS AND METHODS: We studied 84 consecutive liver transplant recipients who achieved a sustained viral response with direct-acting antiviral agents at the University of California Los Angeles. We collected laboratory data before and after the sustained viral response was achieved. Paired t tests were performed.

RESULTS: The mean age and standard deviation of our cohort was 62.4 ± 7.6 years. The mean time from achieving a sustained viral response to last follow-up in our cohort was 19.5 ± 10.8 months. In the entire cohort, there were no changes in mean fasting blood glucose (123 ± 42 vs 120 ± 35 mg/dL; P = .49). We observed a significant improvement in renal function in recipients with stage 1 and 2 chronic kidney disease (82 ± 15 vs 71.16 ± 16 mL/min/1.73 m2; P ⟨ .001) and in those treated within 3 months of liver transplant (75 ± 28 vs 61 ± 16 mL/min/1.73 m2; P = .035). Fasting blood glucose decreased in recipients with a diagnosis of impaired fasting blood glucose (109 ± 16 vs 103 ± 13 mg/dL; P = .001).

CONCLUSIONS: The benefits on glucose metabolism and renal function after a sustained viral response in liver transplant recipients appear to be limited to those with early chronic kidney disease and those treated soon after transplant. The potential benefits from direct-acting antiviral agents on these parameters may be overshadowed by the effects of immunosuppressant therapy.

Author List

Saab S, Barnard A, Challita Y, Adeniyi A, Aziz A, Choi G, Durazo FA, El-Kabany MM, Han SB, Busuttil RW

Author

Francisco A. Durazo MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antiviral Agents
Biomarkers
Blood Glucose
Female
Glomerular Filtration Rate
Hepacivirus
Hepatitis C
Humans
Immunosuppressive Agents
Kidney
Liver Transplantation
Los Angeles
Male
Middle Aged
Risk Factors
Sustained Virologic Response
Time Factors
Treatment Outcome