Successful prolonged treatment of glecaprevir/pibrentasvir for chronic hepatitis C patient with treatment failure after 8-week therapy: a 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.
['Naganuma|Atsushi|A|', 'Sato|Ken|K|http://orcid.org/0000-0002-3202-7983', 'Fukuchi|Toru|T|', 'Namikawa|Masashi|M|', 'Kakizaki|Satoru|S|', 'Uraoka|Toshio|T|', 'Ohnishi|Hiroshi|H|', 'Okamoto|Hiroaki|H|']
D000368:Aged D000621:Aminoisobutyric Acids D000998:Antiviral Agents D001562:Benzimidazoles D003521:Cyclopropanes D004359:Drug Therapy, Combination D016679:Genome, Viral D005838:Genotype D016174:Hepacivirus D019698:Hepatitis C, Chronic D006801:Humans D047029:Lactams, Macrocyclic D007930:Leucine D008297:Male D055118:Medication Adherence D011392:Proline D011759:Pyrrolidines D011810:Quinoxalines D012367:RNA, Viral D012008:Recurrence D013449:Sulfonamides D000072230:Sustained Virologic Response D017211:Treatment Failure D016896:Treatment Outcome
Chronic hepatitis C Treatment failure Direct-acting antiviral agents Treatment period Rescue therapy