Summary
Advances in the treatment of
chronic hepatitis C (HCV) have given HCV providers access to treatment
regimens able to achieve
sustained virological response (SVR or
‘cure’) in the majority of patients. There are, however, groups of
patients in whom
HCV treatment outcomes with direct
acting antivirals (DAAs) are suboptimal (genotype (GT) 3 patients,
decompensated cirrhosis,
renal failure) or have not been studied
in large cohorts (patients with cryoglobulinaemia (CG)). This case
outlines the successful
eradication of GT-3 hepatitis C (HCV)
in a patient with decompensated cirrhosis and renal failure secondary to
mixed CG with
DAA failure, using a 12-week course of
sofosbuvir, ledipasvir and ribavirin. The achievement of SVR in this
patient resulted
in significant improvement in hepatic
and renal function. Patients with decompensated cirrhosis and GT-3
disease remain a
difficult to treat population, and the
safety and efficacy of sofosbuvir, ledipasvir and ribavirin in this
cohort require
further study.
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