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Improvement of renal dysfunction in a patient with hepatitis C virus‐related liver cirrhosis by daclatasvir and asunaprevir combination therapy: A case report
Authors:Masataka Tsuge  Akira Hiramatsu  Fumi Shinohara  Norihito Nakano  Yuki Nakamura  Masahiro Hatooka  Kei Morio  Reona Morio  Hiromi Kan  Hatsue Fujino  Takuro Uchida  Tomoki Kobayashi  Takayuki Fukuhara  Keiichi Masaki  Takashi Nakahara  Atsushi Ono  Yuko Nagaoki  Daiki Miki  Tomokazu Kawaoka  Nobuhiko Hiraga  Michio Imamura  Yoshiiku Kawakami  Hiroshi Aikata  Hidenori Ochi  C. Nelson Hayes  Kazuaki Chayama
Affiliation:1. Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan;2. Liver Research Project Center, Hiroshima University, Hiroshima, Japan;3. Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan;4. Laboratory for Digestive Diseases, Center for Genomic Medicine, The Institute of Physical and Chemical Research (RIKEN), Hiroshima, Japan
Abstract:Recently, treatments for chronic hepatitis C virus (HCV) infection have been drastically improved by the development of direct‐acting antiviral agents. In September 2014, dual oral therapy using daclatasvir (DCV) and asunaprevir (ASV) was approved for the treatment of chronic HCV infection in Japan. We treated a patient with HCV‐related liver cirrhosis with severe leg edema due to chronic renal dysfunction using this dual oral therapy. Although serum alanine aminotransferase increased rapidly during the first week of treatment, the antiviral therapy was able to continue, and liver function recovered spontaneously. After 1 month of treatment, serum HCV RNA became continuously undetectable, and serum albumin level gradually increased. Throughout the therapy, serum creatinine level nearly normalized, and leg edema gradually improved. These improvements continued after the combination therapy was completed. HCV RNA remained undetectable following the end of therapy, and sustained virological response at 12 weeks was achieved. It has been reported that chronic HCV infection is associated with renal dysfunction and that HCV eradication can improve it. DCV and ASV combination therapy is safe for patients who have renal dysfunction and may be a suitable therapy for chronic hepatitis C patients with renal dysfunction.
Keywords:asunaprevir  daclatasvir  hepatitis C virus  liver cirrhosis  renal dysfunction
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