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
• Main Authors: Marcos Mucenic, Ajacio Bandeira de Melo Brandão, Claudio Augusto Marroni, Alfeu de Medeiros Fleck Junior, Maria Lucia Zanotelli, Ian Leipnitz, Mário Henrique Meine, Guillermo Kiss, Juliano Martini, Eduardo Soares Schlindwein, Ane Micheli Costabeber, Fernanda Karlinsky Rodrigues Sacco, Giovana Rossato, Guido Pio Cracco Cantisani
• Format: Article in Journal/Newspaper
• Language: English; Portuguese
• Published: Universidade de São Paulo 2019
• Subjects: Hepatitis C virus; Liver transplantation; Treatment; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201961012; https://doaj.org/article/1a86acac792b4e9d922af31469fed7f6

ABSTRACT 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.