Clinical Journal of Gastroenterology

, Volume 12, Issue 6, pp 592–597 | Cite as

Successful prolonged treatment of glecaprevir/pibrentasvir for chronic hepatitis C patient with treatment failure after 8-week therapy: a case report

  • Atsushi Naganuma
  • Ken SatoEmail author
  • Toru Fukuchi
  • Masashi Namikawa
  • Satoru Kakizaki
  • Toshio Uraoka
  • Hiroshi Ohnishi
  • Hiroaki Okamoto
Case Report


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.


Chronic 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.

Human rights

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

Informed consent was obtained from the patient for being included in the Case report.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Department of Gastroenterology, Takasaki General Medical CenterNational Hospital OrganizationTakasakiJapan
  2. 2.Department of Internal MedicineKiryu Kosei General HospitalKiryuJapan
  3. 3.Department of Gastroenterology and HepatologyGunma University Graduate School of MedicineMaebashiJapan
  4. 4.Division of Virology, Department of Infection and ImmunityJichi Medical University School of MedicineShimotsukeJapan

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