Perioperative Ledipasvir–Sofosbuvir for HCV in Liver-Transplant Recipients

In this study of 16 patients with chronic HCV genotype 1 infection who were undergoing liver transplantation from an HCV-negative donor, a 4-week course of once-daily ledipasvir–sofosbuvir achieved a sustained virologic response in 14 of the 15 patients who completed treatment. To the Editor: Hepatitis C virus (HCV) infection continues to be the most frequent indication for liver transplantation, but recurrence of infection is nearly universal in patients who are viremic at the time of transplantation. 1 Direct-acting antiviral agents (DAAs) have been shown to be effective in treating recurrent HCV infection 2 , 3 but have not been tested in preventing reinfection at the time of liver transplantation. Because HCV RNA levels fall precipitously after liver transplantation owing to removal of the liver, the immediate perioperative period before rebound of viremia represents a unique opportunity to cure HCV infection. 4 We hypothesized that a . . .