Abstract
Although NS3/4 protease inhibitor glecaprevir (GLE) plus NS5A inhibitor pibrentasvir (PIB) therapy has a high efficacy for chronic hepatitis C virus (HCV)-infected patients with hemodialysis, some patients fail to respond to the therapy. Here, we report a hemodialysis genotype 2 HCV-infected patient who achieved sustained virological response (SVR) by 12 weeks of GLE/PIB therapy after failing to respond to 8 weeks of GLE/PIB therapy. A 44-year-old man with chronic genotype 2a HCV-infection without any evidence of cirrhosis and who was undergoing hemodialysis received GLE/PIB therapy. He completed 8 weeks of therapy, but his serum HCV relapsed after the end of therapy. No resistance-associated substitutions were detected in the NS3 region, but NS5A-C92C/S was detected by direct sequence analysis prior to the start of therapy and subsequently shifted to NS5A-C92S at the time of HCV relapse. Four months after initial GLE/PIB therapy, he started a 12-week course of GLE/PIB retreatment. Serum HCV RNA level became and remained undetectable during the therapy and never relapsed after the end of the treatment. Finally, he succeeded in achieving sustained virological response following 12 weeks of GLE/PIB retreatment.
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Acknowledgements
We thank Emi Nishio and Akemi Sata for technical assistance. This research is partially supported by research funding from the Research Program on Hepatitis from the Japan Agency for Medical Research and Development, AMED (Grant number: 18fk0210020h0002).
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Michio Imamura has received research funding from Bristol-Myers Squibb. Kazuaki Chayama has received honoraria from Bristol-Myers Squibb and MSD K.K. and research funding from Dainippon Sumitomo Pharma and AbbVie.
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Ohya, K., Imamura, M., Osawa, M. et al. Successful retreatment with 12 weeks of glecaprevir and pibrentasvir for a genotype 2a HCV-infected hemodialysis patient who failed to respond to 8 weeks of prior glecaprevir and pibrentasvir therapy. Clin J Gastroenterol 13, 267–270 (2020). https://doi.org/10.1007/s12328-019-01039-w
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DOI: https://doi.org/10.1007/s12328-019-01039-w