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 inRevista do Instituto de Medicina Tropical de São Paulo Vol. 61; pp. 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 Journal Article
LanguageEnglish
Portuguese
Published Brazil Instituto de Medicina Tropical de Sao Paulo 01.01.2019
Instituto de Medicina Tropical
Universidade de São Paulo (USP)
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
Hepatitis C virus
Treatment
Liver transplantation
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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.
Bibliography:ObjectType-Case Study-3
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ObjectType-Feature-5
ObjectType-Report-2
ObjectType-Article-4
CONFLICT OF INTERESTS
We certify that we have no commercial associations that might pose a conflict of interest in connection with the submitted article.
Marcos Mucenic: data collection, text writing, review of the literature Ajacio B. M. Brandao, Claudio A. Marroni, Alfeu M. Fleck-Junior, Ane M. Costabeber, Fernanda K. F. Sacco, Giovana Rossato: text editing and review of the literature. Maria L. Zanotelli, Ian Leipnitz, Mário H. Meine, Guillermo Kiss, Juliano Martini, Eduardo S. Schlindwein, Guido P.C. Cantisani: text editing
AUTHORS’ CONTRIBUTIONS
ISSN:1678-9946
0036-4665
1678-9946
DOI:10.1590/S1678-9946201961012