Green Victoria, Roytman Marina
Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA.
Department of Gastroenterology and Hepatology, University of California, San Francisco, Fresno, CA, USA.
Case Reports Hepatol. 2022 Mar 11;2022:3556780. doi: 10.1155/2022/3556780. eCollection 2022.
Hepatitis C virus (HCV) is an ongoing global public health threat affecting millions worldwide. Increasing recognition of its impact and recent advances towards HCV prevention and cure have provided incentive for the World Health Organization to call for global elimination by 2030. The goal of therapy is to achieve a sustained virologic response (SVR-12), defined as undetectable HCV-RNA within 12 weeks after treatment completion. In 2011, approval was given for the first direct-acting antiviral agents (DAAs). More recently, in 2013, more effective DAAs, with pan-genomic properties, have been introduced, and these regimens boast increasing rates of SVR. The ultimate goal is that the history of HCV ends with the pan-genotypic efficacy of multiple, easy-to-use and tolerate, combination regimens. These regimens have already demonstrated the ability to cure previously challenging patient groups. However, limitations exist in the current portfolio of agents, with suboptimal outcomes for patients with HCV genotype 3. In addition to this, access to DAAs remains an obstacle for many patients. We present this case of a 61-year-old male with HCV genotype 3 who has had several treatment failures with standard HCV therapy who was eventually approved for compassionate use of a 16-week course of glecaprevir (GLE)/pibrentasvir (PIB), sofosbuvir (SOF), and ribavirin (RBV) which ultimately led to SVR-12.
丙型肝炎病毒（HCV）是一个持续存在的全球公共卫生威胁，影响着全球数百万人。对其影响的认识不断提高，以及近期在丙型肝炎病毒预防和治疗方面取得的进展，促使世界卫生组织呼吁到2030年实现全球消除丙型肝炎病毒的目标。治疗的目标是实现持续病毒学应答（SVR-12），定义为治疗完成后12周内丙型肝炎病毒核糖核酸（HCV-RNA）检测不到。2011年，首个直接抗病毒药物（DAA）获得批准。最近，在2013年，具有泛基因组特性的更有效的DAA药物被引入，这些治疗方案的SVR率不断提高。最终目标是，丙型肝炎病毒的历史随着多种易于使用和耐受的联合治疗方案的泛基因型疗效而终结。这些治疗方案已经证明有能力治愈以前具有挑战性的患者群体。然而，目前的药物组合存在局限性，丙型肝炎病毒基因3型患者的治疗效果欠佳。除此之外，许多患者在获取DAA药物方面仍然存在障碍。我们介绍了一名61岁丙型肝炎病毒基因3型男性患者的病例，他在标准丙型肝炎病毒治疗中经历了多次治疗失败，最终被批准同情使用16周疗程的格卡瑞韦（GLE）/哌仑他韦（PIB）、索磷布韦（SOF）和利巴韦林（RBV），最终实现了SVR-12。
