Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to
cirrhosis, end-stage
liver diseases, and
hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with
proteinuria, transplant glomerulopathy, HCV-associated
glomerulonephritis, and chronic rejection. Previous
therapy involving
interferon alfa and
ribavirin led to treatment complications, including toxicity,
anemia,
sepsis, and drug-drug interactions with
calcineurin inhibitors, as well as reduced tolerability and efficacy. New direct-acting
antiviral drugs simplify and shorten the treatment along with increasing tolerability and efficacy. Nevertheless, limited data and no specific regimen with direct-acting
antiviral drugs have been described in the literature for renal transplant recipients with chronic HCV. We describe here the case of a 52-year-old Chinese man who diagnosed with
chronic renal failure in 1997 and underwent
renal transplantation the same year. In 2012, he was diagnosed with renal graft failure and again underwent
hemodialysis. The patient then underwent his second
renal transplantation and was administered an immunosuppressive
cyclosporine-based regimen in 2015. During
hemodialysis, he acquired asymptomatic genotype 1b HCV
infection. Serologic test results reflecting
liver cirrhosis were all negative, and ultrasound showed no abnormalities in the liver. The patient later required oral
sofosbuvir monotherapy for 12 weeks after the second
kidney transplantation. Curing HCV in renal transplant recipients is necessary. Although our treatment did not successfully result in a sustained virologic response, it suggests that genotype 1b HCV may have a poor response to a
sofosbuvir monotherapy regimen. Specific and effective regimens for renal transplant recipients with HCV
infection need to be confirmed in the future.