Maruyama Anna, Hussaini Trana, Partovi Nilufar, Erb Siegfried R, Azalgara Vladimir Marquez, Zalunardo Nadia, Pick Neora, Hull Mark, Yoshida Eric M
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada.
Can J Infect Dis Med Microbiol. 2016;2016:8372835. doi: 10.1155/2016/8372835. Epub 2016 Mar 30.
Although major advances have occurred in treating patients with hepatitis C virus (HCV) with the development of new direct-acting antivirals (DAAs), treatment of liver transplant recipients with HCV, human immunodeficiency virus (HIV) coinfection, and renal disease is challenging due to the lack of efficacy and safety data in this population. We report a case of successful HCV therapy in a postliver transplant HIV coinfected patient, with stage 4 chronic kidney disease, using an all-oral regimen of simeprevir, sofosbuvir, and ribavirin. The 51-year-old male achieved SVR24, and no specific HIV-related or transplant-related adverse events were documented during the treatment period. The new DAAs show promise for HIV coinfected patients and those with severe to end-stage renal disease (ESRD); however, robust clinical trials or large cohort studies will need to be conducted to confirm the efficacy and safety of these newer agents in this setting.
尽管随着新型直接作用抗病毒药物（DAA）的开发，丙型肝炎病毒（HCV）患者的治疗取得了重大进展，但由于缺乏该人群的疗效和安全性数据，对合并感染HCV、人类免疫缺陷病毒（HIV）和患有肾脏疾病的肝移植受者进行治疗具有挑战性。我们报告了一例肝移植后合并感染HIV且患有4期慢性肾病的患者，使用simeprevir、索磷布韦和利巴韦林的全口服方案成功进行HCV治疗的病例。这位51岁的男性实现了持续病毒学应答24周，并且在治疗期间未记录到任何特定的HIV相关或移植相关不良事件。新型DAA对合并感染HIV的患者以及患有严重至终末期肾病（ESRD）的患者显示出前景；然而，需要进行强有力的临床试验或大型队列研究，以证实这些新型药物在这种情况下的疗效和安全性。
