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Hepatitis C virus cures after direct acting antiviral-related drug-induced liver injury: Case report

World Journal of Hepatology 2016年第20期8卷 858-862页

作者： Yaakov Hasin Shimon Shteingart Harel Dahari Inna Gafanovich Sharon Floru Marius Braun Amir Shlomai Anthony Verstandig Ilana Dery Susan L Uprichard Scott J Cotler Yoav Lurie Liver Unit Digestive Disease Institute Shaare Zedek Medical Center the Program for Experimental and Theoretical Modeling Division of Hepa-tology Department of Medicine Loyola University Medical Center "Bat Yamon" Internal Medicine Day Care Clalit Health Care Organization Liver Institute Rabin Medical Center Beilinson Hospital Petah-Tiqwa Affiliated with the Sackler Faculty of Medicine Invasive Radiology Unit Shaare Zedek Medical Center

The United States Food and Drug Administration recently warned that the direct acting antiviral(DAA) combination hepatitis C virus(HCV) treatment of Paritaprevir, Ombitasvir, Dasabuvir, Ritonavir, and Ribavirin(PODr + R) can cause severe liver injury in patients with advanced liver disease. Drug induced liver injury was observed in a small number of patients with decompensated cirrhosis treated with other DAAs, but has not been reported in patients with compensated cirrhosis. We report a case of a 74-year-old woman with chronic HCV and Child-Pugh class A cirrhosis(compensated cirrhosis) treated with PODr + R. The patient presented on day 14 of PODr + R therapy with jaundice and new-onset ascites. Her total bilirubin level increased to 23 mg/dL and international normalized ratio rose to 1.65, while aminotransferase levels remained relatively stable. Hepatitis C treatment was discontinued on day 24 and she gradually recovered. Follow-up testing showed that she achieved a sustained virologic response. In conclusion, hepatic decompensation developed within two weeks of starting treatment withPODr + R in a patient with Child-Pugh class A cirrhosis and was characterized by jaundice and ascites with stable aminotransferase levels. Careful monitoring is warranted in patients with HCV-related cirrhosis treated with PODr + R.

关键词： Direct antiviral agent Drug-induced liver injury Hepatitis C Mathematical modeling Sustained virolog

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