Impact of Sofosbuvir-Based Therapy on Liver Transplant Candidates with Hepatitis C Virus Infection

Bethany Dellay, Anne Sexter, Jeffrey H. Wang, Gregory P. Hess, W. Ray Kim, Ajay K. Israni

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Sofosbuvir use in patients with decompensated cirrhosis may be associated with reduced liver transplant waitlist mortality and reduced need for transplant. Methods: Data from the Scientific Registry of Transplant Recipients were linked with a national database of pharmacy claims. All adult patients on the liver transplant waitlist on January 1, 2014, or added to the list during 2014, with hepatitis C virus as reason for listing were identified (2009 patients). A subgroup of 1093 unique patients had consistent pharmacy claim capture and observations. We compared patients who were and were not treated with all sofosbuvir-based regimens. Results: During the study period, 154 patients received sofosbuvir-based regimens. These patients had lower model for end-stage liver disease scores and significantly longer waiting times. We found a trend toward significance for more sofosbuvir-treated than untreated patients being removed from the waitlist due to improved condition (4.54% vs 3.19%, p=0.03). In a propensity score-adjusted analysis, sofosbuvir-treated patients were less likely to undergo transplant (hazard ratio 0.57, 95% confidence interval 0.37–0.89, p=0.01). Conclusion: During the study period reflecting early sofosbuvir use, few liver transplant candidates received sofosbuvir. Use was associated with lower incidence of transplant and a trend toward more waitlist removals due to improved condition.

Original languageEnglish (US)
Pages (from-to)424-432
Number of pages9
JournalPharmacotherapy
Volume39
Issue number4
DOIs
StatePublished - Apr 2019
Externally publishedYes

Keywords

  • hepatitis C
  • liver transplantation
  • sofosbuvir

ASJC Scopus subject areas

  • Pharmacology (medical)

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