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Infection

, Volume 46, Issue 5, pp 717–720 | Cite as

HCV very late relapse following an atypical viral kinetics in a HIV patient treated for hepatitis C with direct-acting antivirals

  • Viola Guardigni
  • Valeria Cento
  • Stefano Ianniruberto
  • Lorenzo Badia
  • Marianna Aragri
  • Matteo Conti
  • Carlo Federico Perno
  • Pierluigi Viale
  • Francesca Ceccherini-Silberstein
  • Gabriella Verucchi
Case Report
  • 99 Downloads

Abstract

Direct-acting antivirals (DAAs) for the treatment of HCV have dramatically increased the rate of sustained virological response: patients not achieving sustained virological response represent a challenge and rates of late recurrent viremia are very low. We describe here the first case of a very late HCV relapse, following an atypical kinetics (characterized by a spontaneous but transient HCV clearance after an early virological relapse), in a HIV co-infected patient treated with DAAs. Optimal adherence to the therapy was well documented and a phylogenetic analysis ruled out a possible reinfection from a different HCV strain. In conclusion, our case underlines the importance of a long follow-up (> 48 weeks) after DAAs therapies in HCV–HIV co-infected patients who might benefit the most from a very rigorous virological surveillance.

Keywords

Hepatitis HIV infection Recurrence Antiviral therapy IFN-free regimens Maraviroc 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

References

  1. 1.
    Sikavi C, Chen PH, Lee AD, Saab EG, Choi G, Saab S. Hepatitis C and human immunodeficiency virus co-infection in the era of direct-acting antiviral agents: no longer a difficult to treat population. Hepatology. 2017.  https://doi.org/10.1002/hep.29642.CrossRefPubMedGoogle Scholar
  2. 2.
    Kozbial K, Moser S, Al-Zoairy R, et al. Follow-up of sustained virological responders with hepatitis C and advanced liver disease after interferon/ribavirin-free treatment. Liver Int. 2017.  https://doi.org/10.1111/liv.13629.CrossRefPubMedGoogle Scholar
  3. 3.
    Sarrazin C, Isakov V, Svarovskaia ES, et al. Late relapse versus hepatitis C virus reinfection in patients with sustained virologic response after sofosbuvir-based therapies. Clin Infect Dis. 2017;64:44–52.CrossRefPubMedGoogle Scholar
  4. 4.
    European Association for the Study of the Liver. EASL recommendation on treatment of hepatitis C 2016. J Hepatol. 2017;66:153–94.CrossRefGoogle Scholar
  5. 5.
    Kirby BJ, Symonds WT, Kearney BP, Mathias AA. Pharmacokinetic, pharmacodynamic, and drug-interaction profile of the hepatitis C virus NS5B polymerase inhibitor sofosbuvir. Clin Pharmacokinet. 2015;54:677–90.CrossRefPubMedGoogle Scholar
  6. 6.
    Conti M, Matulli Cavedagna T, Ramazzotti E, et al. Multiplexed therapeutic drug monitoring (TDM) of antiviral drugs by LC–MS/MS. Clin Mass Spectrom. 2018;7:6–17 (ISSN 2376-9998).CrossRefGoogle Scholar
  7. 7.
    Di Maio VC, Cento V, Lenci I, et al. Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies. Liver Int. 2017;37:514–28.CrossRefPubMedGoogle Scholar
  8. 8.
    Uojima H, Murakami S, Nakatani S, et al. Late relapse after a sustained virologic response at 24 weeks after treatment with daclatasvir and asunaprevir combination therapy for chronic hepatitis C virus genotype 1b infection with liver cirrhosis. Intern Med. 2017.  https://doi.org/10.2169/internalmedicine.9671-17.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Klag T, Dietz J, Wernet CR, et al. Hepatitis C “true” late reslapse beyond 48 weeks of sustained virologic response after direct acting antiviral therapy. J Hepatol. 2017;66:862–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Boschi C, Colson P, Tissot-Dupont H, Bernit E, Botta-Fridlund D, Aherfi S. Hepatitis C virus relapse 78 weeks after completion of successful direct-acting therapy. CID. 2017;65:1051–3.CrossRefGoogle Scholar
  11. 11.
    Simmons B, Saleem J, Hill A, Riley RD, Cooke GS. Risk of late relapse or reinfection with hepatitis C virus after achieving a sustained virological response: a systematic review and meta-analysis. Clin Infect Dis. 2016;62:683–94.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Neukam K, Morano-Amado LE, Rivero-Juárez A, et al. HIV-coinfected patients respond worse to direct-acting antiviral-based therapy against chronic hepatitis C in real life than HCV-monoinfected individuals: a prospective cohort study. HIV Clin Trials. 2017;18:126–34.CrossRefPubMedGoogle Scholar
  13. 13.
    Sandmann L, Wilson M, Back D, et al. Anti-retroviral drugs do not facilitate hepatitis C virus (HCV) infection in vitro. Antiviral Res. 2012;96:51 – 8.CrossRefPubMedGoogle Scholar
  14. 14.
    European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2018. J Hepatol. 2018.  https://doi.org/10.1016/j.jhep.2018.03.026 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Viola Guardigni
    • 1
    • 2
  • Valeria Cento
    • 3
  • Stefano Ianniruberto
    • 1
  • Lorenzo Badia
    • 1
    • 2
  • Marianna Aragri
    • 4
  • Matteo Conti
    • 5
  • Carlo Federico Perno
    • 6
  • Pierluigi Viale
    • 1
  • Francesca Ceccherini-Silberstein
    • 4
  • Gabriella Verucchi
    • 1
    • 2
  1. 1.Infectious Diseases Unit, Department of Medical and Surgical Science, S. Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly
  2. 2.Research Centre for the Study of HepatitisUniversity of BolognaBolognaItaly
  3. 3.University of MilanMilanItaly
  4. 4.Department of Experimental MedicineUniversity of Rome Tor VergataRomeItaly
  5. 5.Metropolitan LaboratoryMaggiore HospitalBolognaItaly
  6. 6.Department of Oncology and Heamato-OncologyUniversity of MilanMilanItaly

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