Infectious Diseases Unit, Department of Medical and Surgical Science, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Research Centre for the Study of Hepatitis, University of Bologna, Bologna, Italy.
Infection. 2018 Oct;46(5):717-720. doi: 10.1007/s15010-018-1158-9. Epub 2018 May 26.
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.
直接作用抗病毒药物（DAAs）治疗 HCV 显著提高了持续病毒学应答率：未达到持续病毒学应答的患者是一个挑战，晚期复发病毒血症的发生率非常低。我们在此描述了首例 HIV 合并感染患者在接受 DAA 治疗后出现非常晚期 HCV 复发的病例，其病毒学复发的动力学表现不典型（表现为早期病毒学复发后自发性但短暂的 HCV 清除）。该患者对治疗的依从性非常好，系统进化分析排除了可能由不同 HCV 株引起的再感染。总之，我们的病例强调了 HCV-HIV 合并感染患者在 DAA 治疗后进行长期（>48 周）随访的重要性，此类患者可能最需要进行非常严格的病毒学监测。
