P-9 SAFETY AND EFFECTIVENESS OF DIRECT ACTING AGENTS FOR HCV TREATMENT AFTER LIVER TRANSPLANTATION IN RIO DE JANEIRO (BRAZIL)

Abstract

Introduction: Data concerning HCV treatment using direct acting agents (DAAs) after liver transplantation (LT) remain scarce in Brazil. Aims: To describe safety and effectiveness of HCV treatment using DAAs in LT recipients in a single center from Rio de Janeiro (Brazil). Methods: `This retrospective observational study included adults with HCV infection treated by interferon-free regimens after LT. Recurrent infection in the graft was defined by liver biopsy or persistent elevated aminotransferases, in the absence of vascular and biliary tract complications. Presence of cirrhosis was defined by histological analysis of the graft. Patients were treated from August/2015 to December/2019 according to the Brazilian guidelines. Sustained virological response (SRV) was defined by undetectable HCV-RNA 12 weeks after the end-of-treatment and reported as per-protocol. Results: 116 patients, 63% male, median age 62 (IQR, 57-66) years, 75% genotype 1 and 62% with hepatocellular carcinoma (HCC) previous to LT were included. The overall SVR rate was 96.6% (95%CI, 91.1-98.7). There was no significant difference in SVR rates according to clinical/demographic characteristics, HCV genotype or presence of cirrhosis in the graft. SVR rates were similar in individuals with or without history of HCC before LT [95.8% (95%CI 87.6-98.7) vs 97.7% (95%CI, 85.0-99.7%)], p=0.588. Asthenia was the most frequent adverse event [23.3% (95%CI 16.4-32.0)] and no serious adverse events were observed. The use of ribavirin independently associated with incidence of at least one adverse event [OR=8.71 (95%CI 3.17-23.99)]. Conclusion: HCV treatment with DAAs were safe and highly effective after LT in a real-life cohort in Brazil.