In liver transplant, during anti-viral therapy for
hepatitis C virus (HCV) recurrence, the immunosuppressant
levels should be monitored to prevent both toxicity
and rejection.
Sofosbuvir (SOF) has been used within compassionate
programs for HCV recurrence and, according to pharmacokinetic
analyses, is not supposed to have significant
pharmacological interactions with tacrolimus (Tac) or
ciclosporin.1 This was reported in the review article by
Koff recently published.2 We treated eight transplant
recipients with SOF/ribavirin (RBV) for a severe HCV
recurrence, and observed unexpected Tac/ciclosporin
reduction during SOF