Improvement of renal dysfunction in a patient with hepatitis C virus-related liver cirrhosis by daclatasvir and asunaprevir combination therapy: A case report.

Abstract

Recently, treatments for chronic hepatitis C virus (HCV) infection have been drastically improved by the development of direct-acting antiviral agents. In September 2014, dual oral therapy using daclatasvir (DCV) and asunaprevir (ASV) was approved for the treatment of chronic HCV infection in Japan. We treated a patient with HCV-related liver cirrhosis with severe leg edema due to chronic renal dysfunction using this dual oral therapy. Although serum alanine aminotransferase increased rapidly during the first week of treatment, the antiviral therapy was able to continue, and liver function recovered spontaneously. After 1 month of treatment, serum HCV RNA became continuously undetectable, and serum albumin level gradually increased. Throughout the therapy, serum creatinine level nearly normalized, and leg edema gradually improved. These improvements continued after the combination therapy was completed. HCV RNA remained undetectable following the end of therapy, and sustained virological response at 12 weeks was achieved. It has been reported that chronic HCV infection is associated with renal dysfunction and that HCV eradication can improve it. DCV and ASV combination therapy is safe for patients who have renal dysfunction and may be a suitable therapy for chronic hepatitis C patients with renal dysfunction.

• Authors: Masataka Tsuge, Akira Hiramatsu, Fumi Shinohara, Norihito Nakano, Yuki Nakamura, Masahiro Hatooka, Kei Morio, Reona Morio, Hiromi Kan, Hatsue Fujino, Takuro Uchida, Tomoki Kobayashi, Takayuki Fukuhara, Keiichi Masaki, Takashi Nakahara, Atsushi Ono, Yuko Nagaoki, Daiki Miki, Tomokazu Kawaoka, Nobuhiko Hiraga, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Hidenori Ochi, C Nelson Hayes, Kazuaki Chayama
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 46 Issue 9 Pg. 944-8 (Aug 2016) ISSN: 1386-6346 [Print] Netherlands
• PMID: 26613201 (Publication Type: Case Reports)
• Copyright: © 2015 The Japan Society of Hepatology.