Published online May 6, 2019. doi: 10.12998/wjcc.v7.i9.1043
Peer-review started: December 27, 2018
First decision: January 19, 2019
Revised: February 23, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: May 6, 2019
The effectiveness of sofosbuvir/ribavirin (SOF/RBV) combination therapy, which is one of the 1st-choice therapeutic options for patients with hepatitis C virus (HCV) genotype 2 (HCV-G2) in Japan according to the most recent version of the Japan Society of Hepatology guideline, for patients who experienced failure of the ombitasvir/paritaprevir/ritonavir plus ribavirin (OBV/PTV/r+RBV) combination therapy, which was another option for patients with HCV-G2, is unknown.
We evaluated the effects of SOF/RBV combination therapy in two patients with genotype 2a who could not achieve a sustained virological response (SVR) by OBV/PTV/r+RBV combination therapy. One patient was complicated with Vogt-Koyanagi-Harada (VKH) disease. Resistance-associated variations before SOF/RBV combination therapy were not detected in two patients. Both patients had an SVR at 12 wk after the treatment (SVR12). Regarding adverse events (AEs), itching, chill, a dull feeling in the throat and cough as well as increase of alanine transaminase level were shown in one patient, while a headache and deterioration of light aversion probably due to the recurrence of VKH disease were shown in the other patients. In addition, the latter patient developed arthralgia and morning stiffness approximately 7 wk after the therapy and turned out to be diagnosed with rheumatoid arthralgia.
SOF/RBV therapy might be effective for patients experiencing failure of OBV/PTV/r+RBV therapy, but caution should be taken regarding the AEs.
Core tip: The effectiveness of sofosbuvir/ribavirin (SOF/RBV) therapy was unknown for patients who experienced failure of ombitasvir/paritaprevir/ritonavir plus ribavirin therapy and had hepatitis C virus genotype 2. Although there were only 2 patients, SOF/RBV therapy was effective. However, both patients experienced adverse events including unanticipated development or deterioration of autoimmune diseases. Because SOF/RBV therapy is generally well-tolerated, one of the patients was considered a specific case. However, the cases suggest SOF/RBV therapy should be carefully applied in case of the existence of baseline autoimmune disease. Our case reports warrant future studies, but careful observation during and after treatment is required.