Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin
Interferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV the...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2017/8793895 |
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| author | Hirokazu Suii Itaru Ozeki Ryoji Tatsumi Masakatsu Yamaguchi Mutsuumi Kimura Tomohiro Arakawa Tomoaki Nakajima Yasuaki Kuwata Takumi Ohmura Shuhei Hige Yoshiyasu Karino Joji Toyota |
| author_facet | Hirokazu Suii Itaru Ozeki Ryoji Tatsumi Masakatsu Yamaguchi Mutsuumi Kimura Tomohiro Arakawa Tomoaki Nakajima Yasuaki Kuwata Takumi Ohmura Shuhei Hige Yoshiyasu Karino Joji Toyota |
| author_sort | Hirokazu Suii |
| collection | DOAJ |
| description | Interferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV therapy is more effective against genotype 2 than IFN/RBV therapy. We report a case of a 74-year-old woman with chronic HCV genotype 2b infection. She received five treatments including RBV and IFN therapy before SOF was approved and all of them were ineffective. Therapies that included RBV induced severe anemia and led to discontinuation of treatment. With pegylated IFN/RBV therapy, the maximum change in hemoglobin (Hb) from baseline was −3.7 g/dL. However, SOF/RBV therapy was effective and she achieved sustained virologic response (SVR) with a maximum change in Hb from baseline of only −1.2 g/dL. We also found reticulocyte count was very low during treatment in this case and speculate it was one of the reasons that she developed hemolytic anemia with RBV. In conclusion, SOF/RBV therapy is effective and allowed the patient to achieve SVR. An SOF/RBV regimen is safe and effective for patients who have or are at risk of anemia induced by RBV. |
| format | Article |
| id | doaj-art-23cfa00cf20f4f2f9b8d02ccaeb67c97 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-23cfa00cf20f4f2f9b8d02ccaeb67c972025-02-03T05:59:12ZengWileyCase Reports in Hepatology2090-65872090-65952017-01-01201710.1155/2017/87938958793895Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to RibavirinHirokazu Suii0Itaru Ozeki1Ryoji Tatsumi2Masakatsu Yamaguchi3Mutsuumi Kimura4Tomohiro Arakawa5Tomoaki Nakajima6Yasuaki Kuwata7Takumi Ohmura8Shuhei Hige9Yoshiyasu Karino10Joji Toyota11Department of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanDepartment of Hepatology, Sapporo Kosei General Hospital, 8-5 Kita Sanjo Higashi, Chuo-ku, Sapporo, Hokkaido 060-0003, JapanInterferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV therapy is more effective against genotype 2 than IFN/RBV therapy. We report a case of a 74-year-old woman with chronic HCV genotype 2b infection. She received five treatments including RBV and IFN therapy before SOF was approved and all of them were ineffective. Therapies that included RBV induced severe anemia and led to discontinuation of treatment. With pegylated IFN/RBV therapy, the maximum change in hemoglobin (Hb) from baseline was −3.7 g/dL. However, SOF/RBV therapy was effective and she achieved sustained virologic response (SVR) with a maximum change in Hb from baseline of only −1.2 g/dL. We also found reticulocyte count was very low during treatment in this case and speculate it was one of the reasons that she developed hemolytic anemia with RBV. In conclusion, SOF/RBV therapy is effective and allowed the patient to achieve SVR. An SOF/RBV regimen is safe and effective for patients who have or are at risk of anemia induced by RBV.http://dx.doi.org/10.1155/2017/8793895 |
| spellingShingle | Hirokazu Suii Itaru Ozeki Ryoji Tatsumi Masakatsu Yamaguchi Mutsuumi Kimura Tomohiro Arakawa Tomoaki Nakajima Yasuaki Kuwata Takumi Ohmura Shuhei Hige Yoshiyasu Karino Joji Toyota Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin Case Reports in Hepatology |
| title | Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin |
| title_full | Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin |
| title_fullStr | Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin |
| title_full_unstemmed | Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin |
| title_short | Safety of Sofosbuvir and Ribavirin Combination Therapy in a Patient Who Developed Anemia due to Ribavirin |
| title_sort | safety of sofosbuvir and ribavirin combination therapy in a patient who developed anemia due to ribavirin |
| url | http://dx.doi.org/10.1155/2017/8793895 |
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