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Sofosbuvir/Ribavirin therapy for patients experiencing failure of ombitasvir/paritaprevir/ritonavir + ribavirin therapy: Two cases report and review of literature

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World Journal of Clinical Cases 2019年第9期7卷 1043-1052页

作者： Ken Sato Yuichi Yamazaki Takeshi Kobayashi satoshi takakusagi Norio Horiguchi Satoru Kakizaki Masayasu Andou Yoshihiro Matsuda Toshio Uraoka Hiroshi Ohnishi Hiroaki Okamoto Department of Gastroenterology and Hepatology Gunma University Graduate School of Medicine Department of Nephrology and Rheumatology Gunma University Graduate School of Medicine Department of Diagnostic Radiology and Nuclear Medicine Gunma University Graduate School of Medicine Division of Virology Department of Infection and Immunity Jichi Medical University School of Medicine

BACKGROUND The effectiveness of sofosbuvir/ribavirin(SOF/RBV) combination therapy,which is one of the 1 st-choice therapeutic options for patients with hepatitis C virus(HCV) genotype 2(HCV-G2) in Japan according to the most recent version of the Japan Society of Hepatology guideline, for patients who experienced failure of the ombitasvir/paritaprevir/ritonavir plus ribavirin(OBV/PTV/r+RBV) combination therapy, which was another option for patients with HCV-G2, is unknown.CASE SUMMARY We evaluated the effects of SOF/RBV combination therapy in two patients with genotype 2 a who could not achieve a sustained virological response(SVR) by OBV/PTV/r+RBV combination therapy. One patient was complicated with VogtKoyanagi-Harada(VKH) disease. Resistance-associated variations before SOF/RBV combination therapy were not detected in two patients. Both patients had an SVR at 12 wk after the treatment(SVR12). Regarding adverse events(AEs), itching, chill, a dull feeling in the throat and cough as well as increase of alanine transaminase level were shown in one patient, while a headache and deterioration of light aversion probably due to the recurrence of VKH disease were shown in the other patients. In addition, the latter patient developed arthralgia and morning stiffness approximately 7 wk after the therapy and turned out to be diagnosed with rheumatoid arthralgia.CONCLUSION SOF/RBV therapy might be effective for patients experiencing failure of OBV/PTV/r+RBV therapy, but caution should be taken regarding the AEs.

关键词： Direct-acting antiviral agent failure Hepatitis C Genotype 2 Ribavirin Sofosbuvir Case report

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