The Observed Effect of Gastric Bypass Surgery on Direct-acting Antiviral Treatment: a Case Report
Journal Title: Annals of Hepatology - Year 2018, Vol 17, Issue 3
Abstract
Chronic hepatitis C virus (HCV) infection can be cured with treatment using direct-acting antivirals (DAAs). Although these drugs have been widely studied, information about certain special populations is missing. In this case report we describe a treatment-experienced patient with chronic HCV infection genotype 1b, treated with 150 mg/day simeprevir, 400 mg/day sofosbuvir, and 1,000 mg/ day ribavirin for 24 weeks, after a Roux-and-Y gastric bypass. At steady-state a pharmacokinetic curve was recorded of sofosbuvir, GS-331007, and simeprevir. Ribavirin trough plasma concentration (Ctrough) was determined. The simeprevir area under the-concentration time curve (AUClast) and Ctrough were 9.42 h.mg/L and 0.046 mg/L, respectively. Compared to what was described in the literature, simeprevir exposure was low and therefore the simeprevir dose was increased to 300 mg/day. The increased dose of simeprevir was well tolerated and Ctrough was 0.532 mg/L. Sofosbuvir AUClast and Ctrough were 0.63 h.mg/L and 0.0013 mg/L. GS-331007 AUClast and Ctrough were 21.02 h.mg/L and 0.35 mg/L. Ribavirin Ctrough was 2.5 mg/L. Sofosbuvir, GS-331007, and ribavirin exposure were comparable with levels described in literature. The patient achieved a sustained virological response twelve weeks after the completion of treatment.<br/><br/>
Authors and Affiliations
Elise J. Smolders, Sophie B Willemse, Omar El-Sherif, Saye Khoo, David M Burger
Keywords
Related Articles
- EP ID EP345420
- DOI 10.5604/01.3001.0011.7398
- Views 118
- Downloads 0
Capsulorrhaphy in the management of liver hydatid cyst
Introduction. Hydatid disease is a major health problem in some parts of the world. There are several nonoperative and operative ways to treat hydatic disease. The aim of this retrospective study is to assess the rate of...
Drug-induced liver injury in hospitalized HIV patients: high incidence and association with drugs for tuberculosis
Background. The evaluation of liver disease in HIV patients is cumbersome because may result from a number of different causes. The aim of this retrospective study was to estimate the incidence of severe drug induced liv...
External validation and comparison of six prognostic models in a prospective cohort of HBV-ACLF in China
Background. Acute-on-chronic liver failure has high mortality. Currently, robust models for predicting the outcome of hepatitis B virus (HBV)-associated ACLF are lacking. Aim. To assess and compare the performance of si...
Clinical and basal aspects of anemia during antiviral therapy for hepatitis C
Background and Rationale. Anemia is a major side effect of combination therapy for chronic hepatitis C. In this study, severity, potential risk factors for and potential underlying mechanisms of anemia were evaluated. Pa...
An update on the management of hepatitis C: guidelines for protease inhibitor-based triple therapy from the Latin American Association for the Study of the Liver
Hepatitis C is a common cause of end-stage liver disease, and the main indication for liver transplantation in Latin America. Treatment of hepatitis C infected patients improves important long-term outcomes as mortality....