Sofosbuvir, ribavirin and pegylated interferon for a daclatasvir-resistent genotype 3 hepatitis C virus: case report and review

Chronic Hepatitis C relapse after liver transplantation can lead to graft failure within a short time period. The high efficacy and good safety profile of direct-acting antivirals has led to consensual recommendations for using interferon-free treatment after liver transplantation. However, pegylate...

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Published in:Revista do Instituto de Medicina Tropical de São Paulo 2019-01, Vol.61, p.e12-4
Main Authors: Mucenic, Marcos, Brandão, Ajacio Bandeira de Melo, Marroni, Claudio Augusto, Fleck Junior, Alfeu de Medeiros, Zanotelli, Maria Lucia, Leipnitz, Ian, Meine, Mário Henrique, Kiss, Guillermo, Martini, Juliano, Schlindwein, Eduardo Soares, Costabeber, Ane Micheli, Sacco, Fernanda Karlinsky Rodrigues, Rossato, Giovana, Cantisani, Guido Pio Cracco
Format: Article
Language:English
Subjects:
Aged
Antiviral Agents - administration & dosage
Case Report
Drug Therapy, Combination
Genotype
Hepacivirus - genetics
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Humans
Interferon alpha-2 - administration & dosage
Interferon-alpha - administration & dosage
Liver Transplantation
Male
Polyethylene Glycols - administration & dosage
Recombinant Proteins - administration & dosage
Ribavirin - administration & dosage
Sofosbuvir - administration & dosage
Treatment
TROPICAL MEDICINE
Viral Load
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Summary:Chronic Hepatitis C relapse after liver transplantation can lead to graft failure within a short time period. The high efficacy and good safety profile of direct-acting antivirals has led to consensual recommendations for using interferon-free treatment after liver transplantation. However, pegylated interferon may still be required for genotype 3 non-responders. We treated a liver graft recipient with grade 1 fibrosis in the biopsy with daclatasvir and sofosbuvir for 12 weeks. He did not respond and progressed to grade 3 fibrosis. Lacking other options, we obtained a sustained virological response with pegylated interferon, ribavirin and sofosbuvir for 12 weeks. The combination of pegylated interferon, ribavirin and sofosbuvir is a viable option after the failure of direct acting antivirals in economically disadvantaged countries.
ISSN:1678-9946
0036-4665
1678-9946
DOI:10.1590/S1678-9946201961012