Revista do Instituto de Medicina Tropical de São Paulo (Feb 2019)

Sofosbuvir, ribavirin and pegylated interferon for a daclatasvir-resistent genotype 3 hepatitis C virus: case report and review

  • Marcos Mucenic,
  • Ajacio Bandeira de Melo Brandão,
  • Claudio Augusto Marroni,
  • Alfeu de Medeiros Fleck Junior,
  • Maria Lucia Zanotelli,
  • Ian Leipnitz,
  • Mário Henrique Meine,
  • Guillermo Kiss,
  • Juliano Martini,
  • Eduardo Soares Schlindwein,
  • Ane Micheli Costabeber,
  • Fernanda Karlinsky Rodrigues Sacco,
  • Giovana Rossato,
  • Guido Pio Cracco Cantisani

DOI
https://doi.org/10.1590/s1678-9946201961012
Journal volume & issue
Vol. 61, no. 0

Abstract

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ABSTRACT Chronic Hepatitis C relapse after liver transplantation can lead to graft failure within a short time period. The high efficacy and good safety profile of direct-acting antivirals has led to consensual recommendations for using interferon-free treatment after liver transplantation. However, pegylated interferon may still be required for genotype 3 non-responders. We treated a liver graft recipient with grade 1 fibrosis in the biopsy with daclatasvir and sofosbuvir for 12 weeks. He did not respond and progressed to grade 3 fibrosis. Lacking other options, we obtained a sustained virological response with pegylated interferon, ribavirin and sofosbuvir for 12 weeks. The combination of pegylated interferon, ribavirin and sofosbuvir is a viable option after the failure of direct acting antivirals in economically disadvantaged countries.

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