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04 June 2020 : Case report  USA

Sustained Virologic Suppression After 4 Weeks of Ledipasvir/Sofosbuvir in Human Immunodeficiency Virus (HIV)/Hepatitis C Virus (HCV) Co-Infection

Unusual or unexpected effect of treatment, Clinical situation which can not be reproduced for ethical reasons

Joshua P. Havens12ABDEF*, Nichole N. Regan1BE, Sara H. Bares1ADEF

DOI: 10.12659/AJCR.923326

Am J Case Rep 2020; 21:e923326

Abstract

BACKGROUND: Short-course hepatitis C (HCV) treatment with direct-acting antivirals (DAA) under 8 weeks in duration has resulted in variable efficacy rates in HCV mono-infection. Further, DAA courses under 8 weeks in duration have not been studied in HIV/HCV co-infection. We present a case report of 12-week sustained virologic suppression after treatment interruption of ledipasvir/sofosbuvir at 4 weeks in a patient with HIV/HCV co-infection.

CASE REPORT: A 28-year-old male patient diagnosed with well-controlled HIV infection and HCV co-infection (treatment-naïve, genotype 1a, unknown hepatic fibrosis) started a 12-week course of ledipasvir/sofosbuvir (LDV/SOF) for HCV treatment. The patient completed only 4 weeks of LDV/SOF before returning for follow-up 7 weeks after initiation. Ledipasvir/sofosbuvir treatment was discontinued. Sustained virologic suppression at 12 weeks was observed after completion of a short, 4-week course of LDV/SOF.

CONCLUSIONS: Compared to currently recommended treatment durations, clinical trials of short-course DAA treatments of less than 8 weeks have not demonstrated successful rates of SVR12. However, in cases of DAA interruption or incomplete treatment, clinicians may choose to assess for SVR12 prior to continuing or restarting the full treatment course.

Keywords: Antiviral Agents, Hepatitis C, HIV Infections, Adult, Benzimidazoles, coinfection, Drug Therapy, Combination, Fluorenes, Hepatitis C, Chronic, Sofosbuvir, Sustained Virologic Response

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923