{"doi":"10.1093/ndt/gfae271","title":"Prophylactic 2-week glecaprevir/pibrentasvir in hepatitis C positive-to-negative kidney transplantation","abstract":"BACKGROUND AND HYPOTHESIS: Hepatitis C virus (HCV) positive-to-negative kidney transplants require direct-acting antiviral therapy, but the optimal timing and duration remain unclear. We hypothesized that a 14-day prophylactic course of glecaprevir/pibrentasvir 300/120 mg (GLE/PIB) would be safe and effective at treating donor-derived HCV viremia. METHODS: This was a prospective, single-center, single-arm, open-label pilot study. Twenty adult HCV-negative recipients of HCV nucleic acid amplification test positive deceased-donor kidneys (HCV positive-to-negative) received a 14-day course of GLE/PIB, with the first dose pretransplant. HCV RNA viral load (VL) was monitored on postoperative days (POD) 1, 3, 7, and 13. If VL was undetectable on POD 13, GLE/PIB was stopped, and if detectable, GLE/PIB was continued to complete an 8-week course. Surveillance monitoring continued after treatment to ensure sustained viral response (SVR). The primary outcome was efficacy of 14-day prophylactic GLE/PIB. Secondary outcomes included patient and allograft survival, the incidence, timing, and clearance of HCV viremia, and safety events. RESULTS: Seven out of 20 subjects (35%) never developed detectable HCV viremia. Only one subject had a detectable, but nonquantifiable, VL on POD 13 and completed an 8-week course. All subjects achieved SVR 12 weeks post-treatment with no relapses through 1-year follow-up. Mean time to undetectable HCV RNA VL was 10.5 (±4.7) days and mean peak VL was 371 (±715) copies/mL. Six-month and 1-year patient and allograft survival were 100% and 95%. CONCLUSION: A 14-day course of prophylactic GLE/PIB is safe and effective for HCV positive-to-negative kidney transplants and may prevent HCV transmission or significantly reduce the VL for those with detectable transmission, allowing rapid clearance within 2 weeks.","journal":"Nephrology Dialysis Transplantation","year":2024,"id":482328,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.952,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":72300,"name":"Aprajita Mattoo","orcid":null,"position":1,"is_corresponding":false},{"id":1322899,"name":"Perry Hotchkis","orcid":null,"position":2,"is_corresponding":false},{"id":72267,"name":"Ian S. Jaffe","orcid":"0000-0002-7309-308X","position":3,"is_corresponding":false},{"id":49808,"name":"Elaina Weldon","orcid":null,"position":4,"is_corresponding":false},{"id":1286773,"name":"Jonathan Berger","orcid":"0000-0002-9085-0900","position":5,"is_corresponding":false},{"id":1298151,"name":"Nicole Ali","orcid":"0000-0003-1209-2873","position":6,"is_corresponding":false},{"id":1149913,"name":"Robert A. Montgomery","orcid":"0000-0001-9914-6082","position":7,"is_corresponding":false},{"id":1230416,"name":"Bonnie E. Lonze","orcid":"0000-0002-0973-1657","position":8,"is_corresponding":false},{"id":714292,"name":"Rebecca Dieter","orcid":"0000-0001-7906-1372","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T02:07:14.349221Z","pmid":"39568065","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}