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Journal Articles Viruses Year : 2023

Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?

Lucy Meunier
Mohamed Belkacemi
  • Function : Author
George Philippe Pageaux
  • Function : Author
Sylvie Radenne
  • Function : Author
Anaïs Vallet-Pichard
  • Function : Author
Christophe Duvoux
  • Function : Author
Danielle Botta-Fridlund
  • Function : Author
Victor de Ledinghen
  • Function : Author
Filomena Conti
  • Function : Author
Rodolphe Anty
Vincent Di Martino
  • Function : Author
Marilyne Debette-Gratien
  • Function : Author
Vincent Leroy
  • Function : Author
Theophile Gerster
  • Function : Author
Pascal Lebray
  • Function : Author
Laurent Alric
  • Function : Author
Armand Abergel
Jérôme Dumortier
  • Function : Author
Camille Besch
  • Function : Author
Helene Montialoux
  • Function : Author
Didier Samuel
  • Function : Author
Jean-Charles Duclos-Vallée
  • Function : Author
Audrey Coilly

Abstract

Background: Direct-acting antiviral (DAA) agents for the treatment of hepatitis C virus (HCV) infection have been proven safe and effective in cirrhotic patients awaiting liver transplantation (LT). However, in the long term, data remain minimal regarding the clinical impact of viral eradication on patients listed for decompensated cirrhosis or hepatocellular carcinoma (HCC). We aimed to elucidate the clinical outcomes of patients regarding delisting and the evolution of HCC during the long-term follow-up. Methods: An observational, multicenter, retrospective analysis was carried out on prospectively collected data from HCV-positive patients treated with an interferon-free regimen while awaiting LT in 18 French hospitals. Results: A total of 179 patients were included in the study. The indication for LT was HCC in 104 (58.1%) patients and cirrhosis in 75 (41.9%) patients. The sustained virological response was 84.4% and the treatment was well tolerated. At five years, among 75 patients with cirrhosis treated for HCV, 19 (25.3%) were delisted following improvement after treatment. Predictive factors for delisting highlighted an absence of ascites, MELD score ≤ 15, and Child–Pugh score ≤ 7. No patients with refractory ascites were delisted. Among patients with HCC, 82 (78.9%) were transplanted. The drop-out rate was low (6.7%) and few recurrences of HCC after LT were observed. Conclusions: DAAs are safe and effective in patients awaiting LT for cirrhosis or HCC. A quarter of patients with cirrhosis can be delisted because of clinical improvement. Predictive factors for delisting, as a result of improvement, may assist prescribers, before initiating HCV infection therapy in the long-term perspective.
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hal-03980202 , version 1 (30-05-2023)

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Lucy Meunier, Mohamed Belkacemi, George Philippe Pageaux, Sylvie Radenne, Anaïs Vallet-Pichard, et al.. Patients Treated for HCV Infection and Listed for Liver Transplantation in a French Multicenter Study: What Happens at Five Years?. Viruses, 2023, 15 (1), pp.137. ⟨10.3390/v15010137⟩. ⟨hal-03980202⟩
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