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

• Published in: Revista 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
• Language: English
• 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
• ISSN: 1678-9946; 0036-4665; 1678-9946
• DOI: 10.1590/S1678-9946201961012

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.