Successful twice interrupted therapy of HCV infection in patients with cirrhosis with hepatocellular carcinoma before and after liver transplantation

BMJ Case Rep. 2017 Sep 15:2017:bcr2017220152. doi: 10.1136/bcr-2017-220152.

Abstract

We are presenting the case study of the patient diagnosed at the age of 37 with liver cirrhosis due to genotype 1b hepatitis C virus infection. At the age of 46, he was diagnosed with hepatocellular carcinoma with subsequent resection of the tumour in May 2015. In December 2015, the treatment was started with ombitasvir, paritaprevir/ritonavir and dasabuvir (3D) with ribavirin (RBV) 1000 mg per day. After 24 days of this treatment, the patient received a deceased donor liver transplantation, followed by 18-day interruption of 3D therapy. Due to the anaemia, RBV dose was reduced to 600 mg per day for the rest of the treatment. At the 11th week of 3D+RBV treatment, there was another 8-day long discontinuation of therapy due to the postoperative wound infection. In total, the patient received 24 weeks of 3D+RBV treatment, achieving sustained virological response at week 24 post-treatment.

Keywords: hepatitis and other GI infections; hepatitis c; infections.

Publication types

  • Case Reports

MeSH terms

  • 2-Naphthylamine
  • Anilides / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Carbamates / therapeutic use
  • Carcinoma, Hepatocellular / complications*
  • Carcinoma, Hepatocellular / physiopathology
  • Carcinoma, Hepatocellular / surgery
  • Cyclopropanes
  • Drug Therapy, Combination
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy*
  • Humans
  • Lactams, Macrocyclic
  • Liver Cirrhosis / complications*
  • Liver Neoplasms / complications*
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / surgery
  • Liver Transplantation*
  • Macrocyclic Compounds / therapeutic use
  • Male
  • Middle Aged
  • Proline / analogs & derivatives
  • Ribavirin / therapeutic use
  • Ritonavir / therapeutic use
  • Sulfonamides / therapeutic use
  • Sustained Virologic Response
  • Treatment Outcome
  • Uracil / analogs & derivatives
  • Uracil / therapeutic use
  • Valine

Substances

  • Anilides
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • Lactams, Macrocyclic
  • Macrocyclic Compounds
  • Sulfonamides
  • ombitasvir
  • Ribavirin
  • Uracil
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • Valine
  • Ritonavir
  • paritaprevir