Glecaprevir/Pibrentasvir Treatment in Liver or Kidney Transplant Patients With Hepatitis C Virus Infection

Well-tolerated, ribavirin-free, pangenotypic hepatitis C virus (HCV) treatments for transplant recipients remain a high priority. Once-daily glecaprevir/pibrentasvir demonstrates high rates of sustained virologic response at 12 weeks posttreatment (SVR12) across all major HCV genotypes (GTs). This trial evaluated the safety and efficacy of glecaprevir/pibrentasvir for patients with chronic HCV GT1-6 infection who had received a liver or kidney transplant. MAGELLAN-2 was a phase 3, open-label trial conducted in patients who were ≥3 months posttransplant. Patients without cirrhosis who were HCV treatment-naive (GT1-6) or treatment-experienced (GT1, 2, 4-6; with interferon-based therapy with or without sofosbuvir, or sofosbuvir plus ribavirin) received glecaprevir/pibrentasvir (300/120 mg) once daily for 12 weeks. The primary endpoint compared the percentage of patients receiving glecaprevir/pibrentasvir with SVR12 to a historic SVR12 rate based on the standard of care. Safety of glecaprevir/pibrentasvir was assessed. In total, 80 liver transplant and 20 kidney transplant patients participated in the trial. Most patients had no or minimal fibrosis (80% had fibrosis scores F0-F1) and were infected with HCV GT1 (57%) or GT3 (24%). The overall SVR12 was 98% (n/N = 98/100; 95% confidence interval, 95.3%-100%), which exceeded the prespecified historic standard-of-care SVR12 threshold of 94%. One patient experienced virologic failure. One patient discontinued because of an adverse event considered to be unrelated to treatment; this patient achieved SVR12. Adverse events were mostly mild in severity, and laboratory abnormalities were infrequent. CONCLUSION: Once-daily glecaprevir/pibrentasvir for 12 weeks is a well-tolerated and efficacious, ribavirin-free treatment for patients with chronic HCV GT1-6 infection who have received a liver or kidney transplant. (ClinicalTrials.gov NCT02692703.) (Hepatology 2018; 00:000-000)

Very high Cu(II) adsorption efficacy of designed nano-platelet Mg(OH)(2) assembly

The present work examined the efficacy of designed Mg(OH)(2) nano-platelet assembly (DMGHNPA) for toxic Cu(II) waste removal from water. For this purpose, DMGHNPA with surface area as high as 237 m(2).g(-1) was synthesized by a very simple and cost effective method at room temperature. The results showed that at concentration range of 80-1000 mg.l(-1), extra-ordinarily high e.g. > 99% Cu(II) ion adsorption efficacy was achieved by the DMGHNPA. Based on the experimental data, adsorption mechanism is proposed to explain the extra-ordinary high adsorption efficacy of the DMGHNPA. The efficient adsorption was occurred through Cu-2(NO3)(OH)(3) microspheres formation on the surfaces of self-supported DMGHNPA. The implication of such extra-ordinary high adsorption efficacy of the Mg(OH)(2) nano-platelet assembly is discussed further in the context of toxic waste e.g. Cu(II) ion removal from water

Once-weekly dose of 8400 IU vitamin D(3) compared with placebo: effects on neuromuscular function and tolerability in older adults with vitamin D insufficiency

Background: Vitamin D insufficiency, which is prevalent in older individuals, is associated with bone and muscle weakness and falls. Objective: We examined the effects of a weekly dose of 8400 IU vitamin