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Safe and effective treatment with daclatasvir and asunaprevir in a liver transplant recipient with severe cholestatic hepatitis C
Author(s) -
Ueda Yoshihide,
Kaido Toshimi,
Hatano Etsuro,
Ohtsuru Shigeru,
Uemoto Shinji
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12509
Subject(s) - daclatasvir , medicine , gastroenterology , liver transplantation , interferon , transplantation , liver function , hepatitis c virus , immunology , virus , ribavirin
Severe cholestatic hepatitis C (SCH) is a unique variant of recurrent hepatitis C that occurs after liver transplantation. Unfortunately, the prognosis of SCH is poor, and interferon (IFN) therapy has been reported to not improve the prognosis. We herein report a case of progressive SCH with acute cellular rejection (ACR) and bacterial infection, which was successfully treated using IFN‐free therapy with daclatasvir and asunaprevir. A 43‐year‐old man was diagnosed with SCH and mild ACR at day 48 after liver transplantation, and IFN‐free therapy with daclatasvir and asunaprevir was started. Although he experienced catheter‐related bacteremia on the first day, the IFN‐free therapy was safely continued, which immediately caused his liver function to improve. His bilirubin levels decreased from 11.1 to 2.1 mg/dL and serum hepatitis C virus RNA levels became undetectable after 4 weeks of the treatment. This case indicates that IFN‐free therapy for progressive SCH with acute cellular rejection and bacterial infection is safe and effective, and may improve the outcomes of hepatitis C virus positive transplant recipients.