Ismail B, Benrajab KM, Bejarano P, Ruiz P, Sears D, Tzakis A, Zervos XB. Benign course of residual inflammation at end of treatment of liver transplant recipients after sofosbuvir based therapy. World J Hepatol 2022; 14(3): 602-611 [PMID: 35582292 DOI: 10.4254/wjh.v14.i3.602]
Corresponding Author of This Article
Karim M Benrajab, MD, Assistant Professor, Internal Medicine/Division of Digestive Diseases and Nutrition, University of Kentucky College of Medicine, 770 Rose Street, MN649, Lexington, KY 40536, United States. karimbenrajab@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Mar 27, 2022; 14(3): 602-611 Published online Mar 27, 2022. doi: 10.4254/wjh.v14.i3.602
Benign course of residual inflammation at end of treatment of liver transplant recipients after sofosbuvir based therapy
Bahaaeldeen Ismail, Karim M Benrajab, Pablo Bejarano, Phillip Ruiz, Debbie Sears, Andreas Tzakis, Xaralambos Bobby Zervos
Bahaaeldeen Ismail, Karim M Benrajab, Division of Digestive Diseases and Nutrition, University of Kentucky College of Medicine, Lexington, KY 40536, United States
Pablo Bejarano, Department of Pathology, Cleveland Clinic Florida, Weston, FL 33331, United States
Phillip Ruiz, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL 33136, United States
Debbie Sears, Andreas Tzakis, Xaralambos Bobby Zervos, Department of Liver Transplant, Cleveland Clinic Florida, Weston, FL 33331, United States
Author contributions: Zervos XB and Tzakis A designed the research; Ismail B, Sears D performed the research; Ismail B, Bejarano P, Ruiz P analyzed the data; Sears D, Benrajab KM, Ismail B, and Zervos XB wrote the paper; all authors contributed to critical revision of the manuscript, and saw and approved the final version.
Institutional review board statement: The study was reviewed and approved by Cleveland Clinic Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Authors have no relevant relationships or conflict of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Karim M Benrajab, MD, Assistant Professor, Internal Medicine/Division of Digestive Diseases and Nutrition, University of Kentucky College of Medicine, 770 Rose Street, MN649, Lexington, KY 40536, United States. karimbenrajab@gmail.com
Received: October 23, 2021 Peer-review started: October 23, 2021 First decision: December 2, 2021 Revised: December 16, 2021 Accepted: February 15, 2022 Article in press: February 15, 2022 Published online: March 27, 2022 Processing time: 151 Days and 23 Hours
ARTICLE HIGHLIGHTS
Research background
Liver transplant recipients may undergo liver biopsy for different indications, and persistent inflammation in patients who receive DAAs can be seen despite achieving sustained virologic response (SVR).
Research motivation
Data on the significance of persistent inflammation on histology after successful treatment of hepatitis C infection with Direct-acting antiviral (DAA) therapies is scarce.
Research objectives
We aimed to examine the impact of successful treatment with DAAs on histological changes and to describe the clinical course of residual inflammation in liver transplant recipients.
Research methods
A case series of chronic hepatitis C liver transplant recipients received DAA post-liver transplant and achieved sustained virologic response. Only patients with at least one liver biopsy were included.
Research results
Thirteen patients were included in this case series; all achieved SVR. Twelve patients were found to have persistent inflammation at the end of treatment biopsy. Five patients had follow-up biopsies, all of which had persistent inflammation. However, all patients had preserved graft function up to 2.5 years, except one who had chronic rejection.
Research conclusions
Persistent inflammation can be seen in liver transplant recipients treated with DAAs; however, it did not appear to affect the outcome.
Research perspectives
The findings of our case series shed light on the significance of persistent inflammation in liver transplant recipients post successful DAAs treatment. Further studies are needed to include a more diverse patient population.
