Tanaka Tomohiro, Akamatsu Nobuhisa, Kaneko Junichi, Arita Junichi, Tamura Sumihito, Hasegawa Kiyoshi, Sakamoto Yoshihiro, Kokudo Norihiro
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo.
Hepatol Res. 2016 Jul;46(8):829-32. doi: 10.1111/hepr.12614. Epub 2015 Nov 12.
Antiviral treatment in liver transplant recipients co-infected with hepatitis C virus (HCV) and HIV remains a challenge. We herein report a case of HCV recurrence that was successfully treated using interferon-free anti-HCV therapy with daclatasvir and asunaprevir. A 48-year-old man underwent antiviral therapy with a 24-week course of daclatasvir and asunaprevir for biopsy-proven recurrent HCV 15 months after living donor liver transplantation, following non-response to pre-emptive antiviral treatment with pegylated interferon plus ribavirin. Anti-HIV and immunosuppressive regimens were modified safely. Renal function was feasibly preserved. The anti-HCV effect was remarkable with an undetectable viral load confirmed within 2 weeks, and this patient achieved a sustained virological response after 12 weeks of post-transplantation treatment. No serious adverse events were observed. This case indicates that daclatasvir and asunaprevir for recurrent HCV in a HIV co-infected recipient after liver transplantation is safe and effective.
丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）合并感染的肝移植受者的抗病毒治疗仍然是一项挑战。我们在此报告一例HCV复发病例，该病例使用不含干扰素的daclatasvir和asunaprevir抗HCV疗法成功治疗。一名48岁男性在活体供肝肝移植后15个月，经活检证实为复发性HCV，此前对聚乙二醇干扰素联合利巴韦林的抢先抗病毒治疗无反应，随后接受了为期24周的daclatasvir和asunaprevir抗病毒治疗。抗HIV和免疫抑制方案得到了安全调整。肾功能得到了合理保留。抗HCV效果显著，2周内病毒载量检测不到，该患者在移植后治疗12周后实现了持续病毒学应答。未观察到严重不良事件。该病例表明，daclatasvir和asunaprevir用于肝移植后HIV合并感染受者的复发性HCV是安全有效的。
