Resumen

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 (C_trough) was determined. The simeprevir area under the-concentration time curve (AUC_last) and C_trough 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 C_trough was 0.532 mg/L. Sofosbuvir AUC_last and C_trough were 0.63 h.mg/L and 0.0013 mg/L. GS-331007 AUC_last and C_trough 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.

Palabras clave: Chronic hepatitis C virus infection gastric bypass surgery direct-acting antivirals simeprevir pharmacokinetics.

2018-06-29   |   173 visitas   |   Evalua este artículo 0 valoraciones

Vol. 17 Núm.3. Mayo-Junio 2018 Pags. 525-529 Ann Hepatol 2018; 17(3)