Successful retreatment with sofosbuvir plus ledipasvir for cirrhotic patients with hepatitis C virus genotype 1b, who discontinued the prior treatment with asunaprevir plus daclatasvir: A case series and review of the literature.

Abstract

BACKGROUND:

Interferon-free treatment results in higher sustained virologic response (SVR) rates, with no serious adverse events in hepatitis C virus (HCV)-infected patients. However, in some patients with treatment-failure in HCV NS5A inhibitor-including interferon-free regimens, the treatment-emergent HCV NS5A resistance-associated variants (RAVs), which are resistant to interferon-free retreatment including HCV NS5A inhibitors, are observed. In HCV-infected Japanese patients with daclatasvir and asunaprevir treatment failure, retreatment with sofosbuvir and ledipasvir could lead to only ∼70% SVR rates.

CASE SUMMARY:

Three HCV genotype (GT)-1b-infected cirrhotic patients who discontinued the combination of daclatasvir and asunaprevir due to adverse drug reactions within 4 weeks; retreatment with sofosbuvir and ledipasvir combination could result in SVR in these patients without RAVs. One HCV GT-1b-infected cirrhotic patient who discontinued the combination of daclatasvir and asunaprevir due to viral breakthrough at week 10; retreatment with sofosbuvir and ledipasvir combination for this patient with the treatment-emergent HCV NS5A RAV-Y93H resulted in viral relapse at week 4 after the end of the treatment.

CONCLUSION:

Retreatment with sofosbuvir and ledipasvir is effective for HCV GT-1b patients who discontinue the combination of daclatasvir and asunaprevir within 4 weeks. The treatment response should be related to the existence of treatment-emergent HCV NS5A RAVs, but may not be related to the short duration of treatment.

• Authors: Yuki Haga, Tatsuo Kanda, Shin Yasui, Masato Nakamura, Yoshihiko Ooka, Koji Takahashi, Shuang Wu, Shingo Nakamoto, Makoto Arai, Tetsuhiro Chiba, Hitoshi Maruyama, Osamu Yokosuka, Nobuo Takada, Mitsuhiko Moriyama, Fumio Imazeki, Naoya Kato
• Journal: Oncotarget (Oncotarget) Vol. 9 Issue 4 Pg. 5509-5513 (Jan 12 2018) ISSN: 1949-2553 [Electronic] United States
• PMID: 29435197 (Publication Type: Journal Article)