Successful treatment of hepatitis C virus infection with sofosbuvir and simeprevir in the early phase of an allogeneic stem cell transplant

Transpl Infect Dis. 2016 Feb;18(1):89-92. doi: 10.1111/tid.12474. Epub 2016 Feb 9.

Abstract

Currently, a lack of consensus exists on how to manage a hepatitis C virus (HCV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Ribavirin alone, or in combination with interferon, has been the mainstream therapy for HCV infection after transplantation. However, very few patients have been regularly treated owing to concerns about poor tolerability, frequent side effects, and limited efficacy. The present case illustrates the striking efficacy of the combination therapy of sofosbuvir with simeprevir, early after transplantation, as it was able to completely eliminate viral replication within 1 month of initiation of treatment. Moreover, tolerance was good, with only minor interactions between the immunosuppressive drugs. This case report supports the feasibility of using this combination therapy early after allo-HSCT for patients with HCV infection.

Keywords: allogeneic stem cells transplantation; direct-acting antivirals; graft-versus-host disease; hepatitis C virus; liver disease; reduced-intensity conditioning; ribavirin; simeprevir; sofosbuvir.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepacivirus / physiology
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Middle Aged
  • Ribavirin / therapeutic use
  • Simeprevir / therapeutic use*
  • Sofosbuvir / therapeutic use*
  • Stem Cell Transplantation*
  • Transplant Recipients
  • Transplantation, Homologous
  • Viral Load / drug effects
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • Ribavirin
  • Simeprevir
  • Sofosbuvir