Skip to main content

Advertisement

SpringerLink
Log in

Sustained virological response after a 17-day treatment with daclatasvir plus asunaprevir in a cirrhotic patient with hepatitis C virus genotype 1b and null response for peginterferon ribavirin therapy

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Daclatasvir (DCV) plus asunaprevir (ASV) treatment, an oral therapy for chronic hepatitis C virus (HCV) genotype 1b infection, can achieve a high sustained viral response (SVR) rate within a 24-week treatment period. A 55-year-old Japanese female with cirrhosis and null response for peginterferon plus ribavirin therapy received DCV plus ASV therapy, but she reported a slight fever beginning on treatment day 4. The fever increased to >38.0 °C beginning on treatment day 15 and could not be controlled with antipyretics; thus, the treatment was discontinued on day 17. Although the patient was still positive for HCV RNA 6 days after treatment discontinuation, she achieved an SVR at week 24 after treatment cessation. In some patients with HCV genotype 1b infection, an SVR can be achieved with short-term DCV plus ASV treatment, and HCV RNA positivity at the end of treatment does not always indicate virological failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Pawlotsky JM. New hepatitis C therapies: the toolbox, strategies, and challenges. Gastroenterology. 2014;46:1176–92.

    Article  Google Scholar 

  2. Kumada H, Suzuki Y, Ikeda K, et al. Daclatasvir plus asunaprevir for chronic HCV genotype 1b infection. Hepatology. 2014;59:2983–91.

    Article  Google Scholar 

  3. Manns M, Pol S, Jacobson IM, et al. All-oral daclatasvir plus asunaprevir for hepatitis C virus genotype 1b: a multinational, phase 3, multicohort study. Lancet. 2014;384:1597–605.

    Article  CAS  PubMed  Google Scholar 

  4. Chayama K, Takahashi S, Toyota J, et al. Dual therapy with the NS5A inhibitor BMS-790052 and the NS3 protease inhibitor BMS-650032 in HCV genotype 1b-infected null responders. Hepatology. 2012;55:742–8.

    Article  CAS  PubMed  Google Scholar 

  5. Suzuki Y, Ikeda K, Suzuki F, et al. Dual oral therapy with daclatasvir and asunaprevir for patients with HCV genotype 1b infection and limited treatment options. J Hepatol. 2013;58:655–62.

    Article  CAS  PubMed  Google Scholar 

  6. Kinugasa H, Ikeda F, Takaguchi K, et al. Low frequency of drug-resistant virus did not affect the therapeutic efficacy in daclatasvir plus asunaprevir therapy in patients with chronic HCV genotype 1 infection. Antivir Ther. 2015;. doi:10.3851/IMP2976.

    PubMed  Google Scholar 

  7. Lok A, Gardiner DF, Hézode C, et al. Randomized trial of daclatasvir and asunaprevir with or without PegIFN/RBV for hepatitis C virus genotype 1 null responder. J Hepatol. 2014;60:490–9.

    Article  CAS  PubMed  Google Scholar 

  8. Akuta N, Sezaki H, Suzuki F, et al. Relationships between serum asunaprevir concentration and alanine aminotransferase elevation during daclatasvir plus asunaprevir for chronic HCV genotype 1b infection. J Med Virol. 2016;88:506–11.

    Article  CAS  PubMed  Google Scholar 

  9. Ghany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009;4:1335–74.

    Article  Google Scholar 

  10. Rosen HR. Emerging concepts in immunity to hepatitis C virus infection. J Clin Invest. 2013;123:4121–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Martin B, Hennecke N, Lohmann V, et al. Restoration of HCV-specific CD8+ T cell function by interferon-free therapy. J Hepatol. 2014;61:538–43.

    Article  CAS  PubMed  Google Scholar 

  12. Serti E, Chepa-Lotrea X, Kim YJ, et al. Successful interferon-free therapy of chronic hepatitis C virus infection normalizes natural killer cell function. Gastroenterology. 2015;149:190–200.

    Article  CAS  PubMed  Google Scholar 

  13. Gudotti LG, Chisari FV. Noncytolytic control of viral infections by the innate and adaptive immune response. Annu Rev Immunol. 2001;19:65–91.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, 1197-1 Yasashicho Asahi-ku, Yokohama, 241-0811, Japan

    Akira Sato, Toshiya Ishii, Kayo Adachi, Daisuke Kumon, Tomohiro Tamura & Youhei Noguchi

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan

    Nobuyuki Matsumoto & Chiaki Okuse

Authors
  1. Akira Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiya Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kayo Adachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daisuke Kumon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomohiro Tamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Youhei Noguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nobuyuki Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chiaki Okuse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akira Sato.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical conditions

The study protocol was approved by the Medical Ethics Committee of St. Marianna University School of Medicine Yokohama City Seibu Hospital. This investigation conformed to the principles outlined in the Declaration of Helsinki.

Informed consent

Informed consent was obtained from the patient prior to the publication of this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sato, A., Ishii, T., Adachi, K. et al. Sustained virological response after a 17-day treatment with daclatasvir plus asunaprevir in a cirrhotic patient with hepatitis C virus genotype 1b and null response for peginterferon ribavirin therapy. Clin J Gastroenterol 9, 89–92 (2016). https://doi.org/10.1007/s12328-016-0630-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-016-0630-2

Keywords

Search

Navigation