A 73-years-old woman with genotype 2a chronic hepatitis C (CHC) could achieve SVR with ombitasvir/paritaprevir/ritonavir/ribavirin (OBV/PTV/r+RBV) after virologic failure with sofosbuvir/ribavirin (SOF+RBV). Although resistance-associated substitutions (RASs) in the hepatitis C virus (HCV) NS5B regions was not detected before and after SOF+RBV, she could not achieve SVR. Therefore OBV/PTV/r+RBV was administered for the patient, because OBV/PTV/r+RBV regimen for genotype 2a CHC patients showed high SVR rate in Japanese phase 3 study. After the completion of OBV/PTV/r+RBV, the patient could achieve SVR12. SOF, OBV, and PTV have the different mechanisms for elimination of HCV and that might be the reasons for why the patient could achieve SVR with OBV/PTV/r+RBV after virologic failure with SOF+RBV.
