[Short-term sustained virological response in a patient with liver cirrhosis, hepatitis C, and declining hepatic spare ability during treatment with direct-acting antivirals]

Nihon Shokakibyo Gakkai Zasshi. 2018;115(5):476-484. doi: 10.11405/nisshoshi.115.476.
[Article in Japanese]

Abstract

A 75-year-old female patient with liver cirrhosis and hepatitis C was treated with direct-acting antivirals (DAA) (Sofosbuvir+Ledipasvir). The hepatitis C virus (HCV) -RNA level decreased to negative 4 weeks after the start of the treatment. Six weeks later, she developed ascites and showed declining hepatic spare ability. Accordingly, DAA treatment was stopped. She was started on furosemide 20mg/day and spironolactone 50mg/day. After 7 days, she started taking tolvaptan 7.5mg/day because furosemide and spironolactone proved to be ineffective. This new regimen resolved the ascites. The HCV-RNA level remained negative, although DAA was not restarted. Finally, she achieved a sustained virological response (SVR). The hepatic spare ability at the time of SVR recovered than that at the time of DAA treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • Female
  • Hepacivirus
  • Hepatitis C / diagnosis
  • Hepatitis C / drug therapy*
  • Hepatitis C, Chronic
  • Humans
  • Liver Cirrhosis / drug therapy
  • Liver Cirrhosis / virology*

Substances

  • Antiviral Agents