VIEKIRA PAK associated drug-induced interstitial lung disease: Case series with systematic review of literature

The likely etiology of HCV infection was attributed to prior practice of intravenous drug abuse. A provisional diagnosis of DILD was made based on: (1) the temporal relationship of his presentation with the initiation of VIEKIRA PAK, (2) lack of response to empiric antibiotic therapy, and (3) absenc...

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Bibliographic Details
Published in:Clinical and molecular hepatology 2019, 25(2), , pp.218-222
Main Authors: Wong, Yu Jun, Chew, Si Yuan, Hsiang, John Chen, Thurairajah, Prem Harichander, Kumar, Rahul, Teo, Eng Kiong, Gokhale, Roshni Sadashiv, Noor, Imran Bin Mohamed, Tan, Jessica
Format: Article
Language:English
Subjects:
Adult
Antibiotics
Drug Combinations
Drug dosages
Dyspnea
Etiology
Extubation
Genotype & phenotype
Hepatitis C
Hepatitis C - drug therapy
Humans
Infections
Interferon
Letter to the Editor
Liver cirrhosis
Lung diseases
Lung Diseases, Interstitial - diagnosis
Lung Diseases, Interstitial - etiology
Macrocyclic Compounds - adverse effects
Macrocyclic Compounds - therapeutic use
Male
Middle Aged
Patients
Pleural effusion
Respiration, Artificial
Respiratory failure
Respiratory Function Tests
Ritonavir - adverse effects
Ritonavir - therapeutic use
Substance abuse treatment
Sulfonamides - adverse effects
Sulfonamides - therapeutic use
Surveillance
Thorax
Tomography
Tomography, X-Ray Computed
Uracil - adverse effects
Uracil - analogs & derivatives
Uracil - therapeutic use
Ventilators
내과학
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Summary:The likely etiology of HCV infection was attributed to prior practice of intravenous drug abuse. A provisional diagnosis of DILD was made based on: (1) the temporal relationship of his presentation with the initiation of VIEKIRA PAK, (2) lack of response to empiric antibiotic therapy, and (3) absence of positive microbiological or autoimmune tests to explain an alternative etiology. Lung function testing on day 51 since admission showed a moderate restrictive defect with a forced expiratory volume in 1 second (FEV1) over full vital capacity (FVC) ratio of 75%, FEV1 1.89 L (67% predicted), FVC 2.52 L (63% predicted), total lung capacity of 3.97 L (73% predicted), and severe reduction in diffusion capacity with carbon monoxide diffusing capacity (DLCO) (corrected for hemoglobin) value of 29% predicted. The role of ritonavir, a CYP3A inhibitor with no anti HCV activity, in VIEKIRA PAK is to increase the half-life of Paritaprevir which is primarily metabolized via CYP3A4 pathway.
ISSN:2287-2728
2287-285X
2287-285X
DOI:10.3350/cmh.2018.0017