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Journal of Gastrointestinal & Digestive System | ISSN: 2161-069X | Volume: 8
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October 29-30, 2018 | San Francisco, USA
International Conference on
Gastrointestinal Cancer and Therapeutics
4th World Congress on
Digestive & Metabolic Diseases
26th Annual Congress on
Cancer Science and Targeted Therapies
Notes:
Initial efficiency of the direct antiviral agent on HCV infected kidney transplant patients at Cho Ray
Hospital
Tran Xuan Truong, Thai Minh Sam, Hoang Khac Chuan, Du Thi Ngoc Thu, Nguyen Trong Hien, Thai Kinh Luan, Quach Do La, Nguyen Duy Dien, Mai
Viet Nhat Tan, Nguyen Tjhanh Tuan, Pham Dinh Thy Phong, Bui Duc Cam Hong, Nguyen Thi bang Chau and Nguyen Thi Thu Le
Cho Ray Hospital, Vietnam
Purposes: To evaluate the efficiency of DAA (Direct Antiviral Agent), in particular, Sofosbuvir, Ledipasvir in Hepatitis
C treatment for patients with kidney transplants. Take note in the side effects and drug interactions during the treatment
processes.
Method: Intervention, prospective, cohort, case studies, non-randomized, open on to all kidney transplant cases with chronic
Hepatitis C tested positive HCV RNA (+); the patients from the cases above had agreed to be the research’s subjects from
11/2015 to 8/2018 at Cho Ray hospital. Two regimens Sofosbuvir/Ribavirin and Sofosbuvir/Ledipasvir have been used for
treatments, which depend on HCV genotype and liver cirrhosis levels.
Results: In 440 patients who had been observed after kidney transplants, 44 cases anti HCV (+), 29 cases HCV RNA (+) and
4 cases HBV/HCV Confection. There were 15 cases with chronic Hepatitis C participated in study. Males made up 66.6% of
the group with the average age 49±7.06 yrs. There were 6.7% of them not taking full-course treatments. 80% of the patients
were infected with only C virus, while 20% of the patients were co-infected with B and C virus. 40% of them had histories of
previous blood transfusions. The ratio of patients with elevated liver enzymes was 33.3%. Genotype 1 (a and b) was 33.3%,
genotype 2 was 6.7%, genotype 6 was 53.3% and 6.7% unidentifiable genotype. There were 2 cases which were treated with
Sofosbuvir/Ribavirin regimen and 13 cases which were treated with Sofosbuvir/Ledipasvir regimen. Rapid virologic response
(RVR) is 100%. Sustained virologic response (SVR) within 12 weeks and 24 weeks is 100%. Relapse ratio 0%. In regimen using
Sofosbuvir/Ledipasvir, the side effects are mild and transient, including skin irritation, digestive disorders which account for
7.7%. In regimen using Sofosbuvir/Ribavirin, side effects including severe anemia, fatigue, loss of appetite related to Ribavirin
occur in 50% of cases (1/2) which lead to stopping treatment termination after 10 weeks and being replaced with treatment
regimens using Sofosbuvir/Daclatasvir with good results. No major interactions are recorded when being used simultaneously
with immunosuppressive drugs such as Prograf, Sandimmum Neoral, Mycophenolate Mofetil, Prednisone in this research.
No renal failure occurs. Liver enzymes are improved during and after treatment. There is improvement scale of fibroscan after
treatment.
Conclusion: Sofosbuvir/Ledipasvir regimen have proven their effectiveness in treating chronic Hepatitis C genotype 1, 2 and
6 on kidney-transplanted patient, with RVR at 100%, SRV 12 and SRV 24 at 100%. Sofosbuvir/Ribavirin regimen have proven
to be effective in eliminating virus and be economical in treating chronic hepatitis C genotype 2, however, the anemia side
effect of ribavirin need to be considered in case it become serious and now the first-line regimens are Sofosbuvir/Daclatasvir
or Sofosbuvir/Velpatasvir. There is improvement of hepatic fibrosis after treatment DAA.
Biography
Xuan Truong Tran has completed his PhD at the age of 25 years (1989) and postdoctoral studies at Ho Chi Minh Medical University. He is the Chief of Department
of General Medicine 9B1, Cho Ray Hospital, Vietnam from 2016 until now. His medical specialty is General Internal Medicine. In nearly 30 years on the internal
medical field, he had experiences in malaria, infectious diseases and hepatitis, especially hepatitis B and C on kidney transplantation. He has participated more
than 15 researches about malaria and hepatitis in kidney transplantation. He had made some reports in ISN or CAST conferences. He is a member of the Vietnam
Association for the Study of Liver Disease (VASLD), Vietnam Uro-Nephrology Association (VUNA) and member of, International Society of Nephrology (ISN).
Viet Nhat Tan et al., J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C8-085