Successful prolonged treatment of glecaprevir/pibrentasvir for chronic hepatitis C patient with treatment failure after 8-week therapy: a case report
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Direct-acting antiviral agent (DAA)-based therapies have been the 1st choice of antiviral agents for chronic hepatitis C throughout the world. The treatment period of DAA-based therapy has been greatly shortened by the improvement of their efficiency. Thus, glecaprevir (GLE)/pibrentasvir (PIB) therapy has enabled the therapeutic period to be reduced from 12 to 8 weeks in cases of genotype 1 or 2 chronic hepatitis C without liver cirrhosis. Currently, there is no established rescue therapy for patients who experience treatment failure on GLE/PIB therapy; however, some patients have been rescued by other regimens, including sofosbuvir (SOF)/velpatasvir (VEL) plus ribavirin (RBV) therapy and GLE/PIB, SOF, and RBV therapy. We experienced the case of a DAA-naïve non-cirrhotic patient with genotype 2a who showed virologic relapse at post-treatment week 13 following 8-week GLE/PIB therapy. After we confirmed that he did not have resistance-associated substitutions against GLE or PIB, we tried to rescue the patient using prolonged (12-week) GLE/PIB therapy. Fortunately, a sustained virologic response was achieved without any adverse events. Although this was a single-case report and is assumed to be rare, the same regimen might be effective for treatment failure with 8-week GLE/PIB therapy.
KeywordsChronic hepatitis C Direct-acting antiviral agents Rescue therapy Treatment failure Treatment period
Compliance with ethical standards
Conflict of interest
Sato K received lecture fees from MSD K.K. and AbbVie Inc., and research funding from AbbVie. Kakizaki S received lecture fees from MSD K.K., AbbVie Inc. and Gilead Sciences, Inc., and research funding from BMS K.K. and Gilead Sciences, Inc.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from the patient for being included in the Case report.
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