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Takahashi H, Kanda T, Matsumoto N, Mizutani T, Kaneko T, Honda M, Yamana Y, Ishii T, Kumagawa M, Sasaki R, Masuzaki R, Nirei K, Yamagami H, Ogawa M, Matsuoka S, Moriyama M. HCV GT1b-patient with alanine aminotransferase elevation and sustained virologic response achieved by grazoprevir/elbasvir discontinuation. Future Virol 2021. [DOI: 10.2217/fvl-2020-0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In the present Japanese female patient with alanine aminotransferase (ALT) elevation greater than 500 IU/l during combination therapy with grazoprevir/elbasvir against HCV infection, this therapy was stopped at week 8. However, sustained virologic response was achieved. In the present report, we also focused on ALT elevation and sustained virologic response during and after antiviral therapies. The current case report demonstrates that careful monitoring of liver function tests may be required during direct-acting antiviral therapy against HCV infection because it is now possible to treat patients with polypharmacy, patients with chronic kidney disease, patients with cirrhosis or aged patients. Careful attention should be paid to liver damage as one of the adverse events in the use of HCV nonstructural protein 3/4A protease inhibitors. Of interest, many publications have addressed both ALT elevations during direct-acting antiviral therapy and viral clearance in relatively short treatment durations.
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Affiliation(s)
- Hiroshi Takahashi
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Tatsuo Kanda
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Naoki Matsumoto
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Taku Mizutani
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Tomohiro Kaneko
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Masayuki Honda
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Yoichiro Yamana
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Tomotaka Ishii
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Mariko Kumagawa
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Reina Sasaki
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Ryota Masuzaki
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Kazushige Nirei
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Hiroaki Yamagami
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Masahiro Ogawa
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Shunichi Matsuoka
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
| | - Mitsuhiko Moriyama
- Department of Medicine, Division of Gastroenterology & Hepatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173 8610, Japan
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Kanda T, Nakamoto S, Sasaki R, Nakamura M, Yasui S, Haga Y, Ogasawara S, Tawada A, Arai M, Mikami S, Imazeki F, Yokosuka O. Sustained Virologic Response at 24 Weeks after the End of Treatment Is a Better Predictor for Treatment Outcome in Real-World HCV-Infected Patients Treated by HCV NS3/4A Protease Inhibitors with Peginterferon plus Ribavirin. Int J Med Sci 2016; 13:310-5. [PMID: 27076789 PMCID: PMC4829545 DOI: 10.7150/ijms.14953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/15/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Direct-acting antiviral agents against HCV with or without peginterferon plus ribavirin result in higher eradication rates of HCV and shorter treatment duration. We examined which is better for predicting persistent virologic response, the assessment of serum HCV RNA at 12 or 24 weeks after the end of treatment for predicting sustained virologic response (SVR12 or SVR24, respectively) in patients treated by HCV NS3/4A protease inhibitors with peginterferon plus ribavirin. METHODS In all, 149 Japanese patients infected with HCV genotype 1b treated by peginterferon plus ribavirin with telaprevir or simeprevir were retrospectively analyzed: 59 and 90 patients were treated with telaprevir- and simeprevir-including regimens, respectively. HCV RNA was measured by TaqMan HCV Test, version 2.0, real-time PCR assay. SVR12 or SVR24, respectively, was defined as HCV RNA negativity at 12 or 24 weeks after ending treatment. RESULTS Total SVR rates were 78.0% and 66.7% in the telaprevir and simeprevir groups, respectively. In the telaprevir group, all 46 patients with SVR12 finally achieved SVR24. In the simeprevir group, 60 (93.8%) of the total 64 patients with SVR12 achieved SVR24, with the other 4 patients all being previous-treatment relapsers. CONCLUSIONS SVR12 was suitable for predicting persistent virologic response in almost all cases. In simeprevir-including regimens, SVR12 could not always predict persistent virologic response. Clinicians should use SVR24 for predicting treatment outcome in the use of HCV NS3/4A protease inhibitors with peginterferon plus ribavirin for any group of real-world patients chronically infected with HCV.
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Affiliation(s)
- Tatsuo Kanda
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shingo Nakamoto
- 2. Department of Molecular Virology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Reina Sasaki
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masato Nakamura
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shin Yasui
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuki Haga
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sadahisa Ogasawara
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akinobu Tawada
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Makoto Arai
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Fumio Imazeki
- 4. Safety and Health Organization, Chiba University, Chiba, Japan
| | - Osamu Yokosuka
- 1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan
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