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A case report of sofosbuvir and daclatasvirto treat a patient with acute hepatitis C virus genotype 2 monoinfection.

ABSTRACT: Direct-acting antivirals (DAAs) are the first-line treatment for patients with chronic hepatitis C virus (HCV) infection. However, its effects on patients with acute HCV infection are poorly understood, and the data for treatment of DAAs for genotype 2 acute monoinfection patients with HCV are lacking.In this case report, a 26 year-old Chinese female acquired a tattoo and developed fatigue, nausea, and anorexia. Laboratory tests showed abnormal liver function.Five months after the patient acquired a tattoo, laboratory tests showed anti-HCV antibody titers were 26.0?s/co, HCV RNA was 5.74×10?IU/mL, and HCV genotype was 2a. The patient was diagnosed with acute hepatitis C (AHC).HCV RNA did not have spontaneous clearance 12 weeks after the infection of the patient. The patient received sofosbuvir (SOF) and daclatasvir (DCV) combination treatment for 12 weeks.Laboratory tests showed HCV RNA was undetectable at weeks 4, and anti-HCV antibody was in seroconversion at weeks 12 during treatment. The patient achieved a sustained virological response 36 weeks after the end of treatment.Patients with acute HCV genotype 2 monoinfection would benefit from antiviral treatment with SOF and DCV.

SUBMITTER: Li C

PROVIDER: S-EPMC5908610 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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A case report of sofosbuvir and daclatasvirto treat a patient with acute hepatitis C virus genotype 2 monoinfection.

Li Chen C Hu JinHua J

Medicine 20180401 15

<h4>Rationale</h4>Direct-acting antivirals (DAAs) are the first-line treatment for patients with chronic hepatitis C virus (HCV) infection. However, its effects on patients with acute HCV infection are poorly understood, and the data for treatment of DAAs for genotype 2 acute monoinfection patients with HCV are lacking.<h4>Patient concerns</h4>In this case report, a 26 year-old Chinese female acquired a tattoo and developed fatigue, nausea, and anorexia. Laboratory tests showed abnormal liver fu ...[more]

PMID: 29642211

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Project description:RationaleHepatitis B virus (HBV) reactivation caused by immunosuppressive therapy or chemotherapy is well known. The administration of direct-acting antiviral agents (DAAs) to treat hepatitis C virus (HCV) infection has also been reported to cause HBV reactivation. We report a rare case of HBV reactivation in a patient with HCV infection after DAA therapy.Patient concernsIn 1996, a 53-year-old female was identified as infected with HCV at a medical check-up, following which she visited our hospital. She was infected with HCV genotype 2b, and at follow up in 1997, was found to be hepatitis B surface antigen (HBsAg) and antibody against HBsAg negative, antibody against HBV core positive. She then experienced malignant lymphoma in 2001 at 58 years of age. Complete remission was achieved following chemotherapy and autologous peripheral blood stem cell transplantation. In 2014, she remained negative for HBsAg and antibody against HBsAg but positive for antibody against HBV core. In 2015, 12 weeks of sofosbuvir and ribavirin treatment for HCV was started. Serum HCV RNA levels rapidly decreased, and HCV elimination was confirmed at 24 weeks after cessation of DAA treatment. Acute hepatitis B developed at 15 weeks post- sustained virological response without any symptoms and physical examination findings.DiagnosesThis case is speculated to represent HBV reactivation induced by DAA treatment in a patient with previously resolved HBV, based on virologic and clinical status. Genome sequencing revealed the HBV genotype as A2.InterventionsThe patient was treated with nucleotide analog for HBV reactivation once a day.OutcomesSerum HBV-DNA levels decreased, and serum liver enzymes improved following initiation of nucleotide analog treatment. Also, adverse events of nucleotide analog treatment were not observed.LessonsAlthough the risk may be very low, DAA therapy can cause HBV reactivation in chronic hepatitis C patients with prior HBV infection. Thus, those patients must be closely monitored for serum HBV DNA levels during and after DAA treatment.

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A case report of sofosbuvir and daclatasvirto treat a patient with acute hepatitis C virus genotype 2 monoinfection.

Publications

A case report of sofosbuvir and daclatasvirto treat a patient with acute hepatitis C virus genotype 2 monoinfection.

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