Late Relapse after a Sustained Virologic Response at 24 Weeks after Treatment with Daclatasvir and Asunaprevir Combination Therapy for Chronic Hepatitis C Virus Genotype 1b Infection with Liver Cirrhosis

Intern Med. 2018 Apr 1;57(7):951-956. doi: 10.2169/internalmedicine.9671-17. Epub 2017 Dec 8.

Abstract

There have been few studies on relapse after a sustained virological response in hepatitis C virus (HCV) patients treated with interferon-free regimens. Thus, the risk of late relapse in patients treated with interferon-free therapy remains unclear. A 67-year-old woman with HCV genotype 1b and liver cirrhosis received oral daclatasvir and asunaprevir. Combination therapy was stopped after 4 weeks because of an episode of encephalopathy. Nonetheless, an HCV polymerase chain reaction at 24 weeks posttreatment was negative. However, HCV ribonucleic acid was detectable at approximately 62 weeks posttreatment. Very late HCV relapses may occur in patients with liver cirrhosis who receive an interferon-free regimen when the treatment period is insufficient.

Keywords: asunaprevir; daclatasvir; interferon-free regimen; late relapse; liver cirrhosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amino Acid Sequence
  • Antiviral Agents / therapeutic use*
  • Carbamates
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Imidazoles / therapeutic use*
  • Interferons / therapeutic use
  • Isoquinolines / therapeutic use*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy*
  • Phylogeny
  • Polymerase Chain Reaction
  • Pyrrolidines
  • RNA, Viral / analysis
  • Recurrence
  • Sequence Homology, Amino Acid
  • Sulfonamides / therapeutic use*
  • Sustained Virologic Response
  • Valine / analogs & derivatives

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Isoquinolines
  • Pyrrolidines
  • RNA, Viral
  • Sulfonamides
  • Interferons
  • Valine
  • daclatasvir
  • asunaprevir