Evaluation of histological dynamics, kidney function and diabetes in liver transplant patients after antiviral treatment with direct‐acting antivirals: Therapy of HCV‐recurrence

Background Direct‐acting antivirals allow efficient and safe treatment of hepatitis C (HCV) before and after liver transplantation (LT). However, the impact of sofosbuvir on the graft, diabetes, and on kidney function is not answered yet. Primary endpoint of this analysis was the evaluation of kidney function after antiviral treatment (AVT). Secondary endpoints were the assessment of extrahepatic manifestation of HCV‐infection by diabetes mellitus and the histopathological changes in terms of inflammation, content of fat, and fibrosis stage. Methods From 2014 to 4/2015, 100 patients with HCV‐recurrence after LT were successfully treated with AVT. Ninety‐eight received a sofosbuvir‐based regimen. Indication was based on genotype, transplant fibrosis stage, and urgency. Biopsies were evaluated before and after treatment. Renal function and diabetes were assessed before, during, and after AVT. Results All patients achieved sustained virological response. A significant improvement of inflammation (P = 0.001) and fibrosis stage (P = 0.031) were observed. Significantly less insulin was required in 32 patients with diabetes (P