Glecaprevir/pibrentasvir治療不成功であったGenotype 2型症例に対しglecaprevir/pibrentasvir再治療を行った2症例
今回我々は，glecaprevir（GLE）/pibrentasvir（PIB）治療不成功であったgenotype 2型に対し，再度GLE/PIB 12週治療を行い完全著効（SVR）を得られた2症例を経験した．症例1は65歳の慢性肝炎男性．GLE/PIB 8週治療終了後HCV RNAの再燃を認め，再度GLE/PIB 12週治療を行った．再治療開始時NS5A-L28F＋L31M＋C92Sのアミノ酸変異を認めたがSVRを達成した．症例2は51歳，肝硬変女性．他院でGLE/PIB開始後掻痒のため3日目に治療中止．その後当院で再度GLE/PIB治療を開始した．開始時よりナルフラフィン塩酸塩を併用したと...
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| Published in | 肝臓 Vol. 62; no. 6; pp. 357 - 362 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本肝臓学会
01.06.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0451-4203 1881-3593 |
| DOI | 10.2957/kanzo.62.357 |
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| Abstract | 今回我々は，glecaprevir（GLE）/pibrentasvir（PIB）治療不成功であったgenotype 2型に対し，再度GLE/PIB 12週治療を行い完全著効（SVR）を得られた2症例を経験した．症例1は65歳の慢性肝炎男性．GLE/PIB 8週治療終了後HCV RNAの再燃を認め，再度GLE/PIB 12週治療を行った．再治療開始時NS5A-L28F＋L31M＋C92Sのアミノ酸変異を認めたがSVRを達成した．症例2は51歳，肝硬変女性．他院でGLE/PIB開始後掻痒のため3日目に治療中止．その後当院で再度GLE/PIB治療を開始した．開始時よりナルフラフィン塩酸塩を併用したところ有害事象なく12週治療を完遂しSVRを達成した．同種類の薬剤を使用しても治療期間を延長することにより治療効果が得られた症例を経験し，再治療の選択を行う上で興味深い症例と思われたので報告した． |
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| AbstractList | 今回我々は，glecaprevir（GLE）/pibrentasvir（PIB）治療不成功であったgenotype 2型に対し，再度GLE/PIB 12週治療を行い完全著効（SVR）を得られた2症例を経験した．症例1は65歳の慢性肝炎男性．GLE/PIB 8週治療終了後HCV RNAの再燃を認め，再度GLE/PIB 12週治療を行った．再治療開始時NS5A-L28F＋L31M＋C92Sのアミノ酸変異を認めたがSVRを達成した．症例2は51歳，肝硬変女性．他院でGLE/PIB開始後掻痒のため3日目に治療中止．その後当院で再度GLE/PIB治療を開始した．開始時よりナルフラフィン塩酸塩を併用したところ有害事象なく12週治療を完遂しSVRを達成した．同種類の薬剤を使用しても治療期間を延長することにより治療効果が得られた症例を経験し，再治療の選択を行う上で興味深い症例と思われたので報告した． |
| Author | 斎藤, 聡 藤山, 俊一郎 芥田, 憲夫 鈴木, 文孝 保坂, 哲也 小林, 正宏 荒瀬, 康司 小林, 万利子 池田, 健次 熊田, 博光 瀬崎, ひとみ 鈴木, 義之 川村, 祐介 |
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| References | 8) MAVIRET® [interview form]. Ver. 5, AbbVie, Tokyo, 2019 4) Sezaki H, Suzuki F, Hosaka T, et al. Initial- and re-treatment effectiveness of glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C virus-genotype 1/2/3 infections. J Gastroenterol 2019; 54: 916-927 6) Nozaki A, Atsukawa M, Kondo C, et al. The effectiveness and safety of glecaprevir / pibrentasvir in chronic hepatitis C patients with refractory factors in the real world: a comprehensive analysis of a prospective multicenter study. Hepatol Int 2020; 14: 225-238 12) Kumada H, Miyakawa H, Muramatsu T, et al. Efficacy of nalfurafine hydrochloride in patients with chronic liver disease with refractory pruritus: A randomized, double-blind trial. Hepatol Res 2017; 47: 972-982 7) Ohya K, Imamura M, Osawa M, et al. Successful retreatment with 12 weeks of glecaprevir and pibrentasvir for a genotype 2a HCV-infected hemodialysis patient who failed to respond to 8 weeks of prior glecaprevir and pibrentasvir therapy. Clin J Gastroenterol 2020; 13: 267-270 1) Chayama K, Suzuki F, Karino Y, et al. Efficacy and safety of glecaprevir/pibrentasvir in Japanese patients with chronic genotype 1 hepatitis C virus infection with and without cirrhosis. J Gastroenterol 2018; 53: 557-565 5) Ogawa E, Furusyo N, Nakamura M, et al. Glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C genotype 1 or 2 infection: Results from a multicenter, real-world cohort study. Hepatol Res 2019; 49: 617-626 11) Meissner E, Bon D, Prokunina-Olsson P, et al. IFNL4-DG genotype is associated with slower viral clearance in hepatitis C, genotype-1 patients treated with sofosbuvir and ribavirin. J Infect Dis 2014; 209: 1700-1704 3) Kumada H, Watanabe T, Suzuki F, et al. Correction to: Efficacy and safety of glecaprevir/pibrentasvir in HCV-infected Japanese patients with prior DAA experience, severe renal impairment, or genotype 3 infection. J Gastroenterol 2018; 53: 566-575 9) Sezaki H, Suzuki F, Hosaka T, et al. Initial- and re-treatment effectiveness of glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C virus-genotype 1/2/3 infections. J Gastroenterol 2019; 54: 916-927 2) Toyoda H, Chayama K, Suzuki F, et al. Efficacy and safety of glecaprevir/pibrentasvir in Japanese patients with chronic genotype 2 hepatitis C virus infection. Hepatology 2017; 67: 505-513 13) Drafting Committee for Hepatitis Management Guidelines, the Japan Society of Hepatology. Japan Society of Hepatology guidelines for the management of hepatitis C virus infection: 2019 update. Hepatol Res 2020; 50: 791-816 10) Thomas DL, Thio CL, Martin MP, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature 2009; 461: 798-801 |
| References_xml | – reference: 7) Ohya K, Imamura M, Osawa M, et al. Successful retreatment with 12 weeks of glecaprevir and pibrentasvir for a genotype 2a HCV-infected hemodialysis patient who failed to respond to 8 weeks of prior glecaprevir and pibrentasvir therapy. Clin J Gastroenterol 2020; 13: 267-270 – reference: 8) MAVIRET® [interview form]. Ver. 5, AbbVie, Tokyo, 2019 – reference: 10) Thomas DL, Thio CL, Martin MP, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature 2009; 461: 798-801 – reference: 9) Sezaki H, Suzuki F, Hosaka T, et al. Initial- and re-treatment effectiveness of glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C virus-genotype 1/2/3 infections. J Gastroenterol 2019; 54: 916-927 – reference: 12) Kumada H, Miyakawa H, Muramatsu T, et al. Efficacy of nalfurafine hydrochloride in patients with chronic liver disease with refractory pruritus: A randomized, double-blind trial. Hepatol Res 2017; 47: 972-982 – reference: 3) Kumada H, Watanabe T, Suzuki F, et al. Correction to: Efficacy and safety of glecaprevir/pibrentasvir in HCV-infected Japanese patients with prior DAA experience, severe renal impairment, or genotype 3 infection. J Gastroenterol 2018; 53: 566-575 – reference: 1) Chayama K, Suzuki F, Karino Y, et al. Efficacy and safety of glecaprevir/pibrentasvir in Japanese patients with chronic genotype 1 hepatitis C virus infection with and without cirrhosis. J Gastroenterol 2018; 53: 557-565 – reference: 5) Ogawa E, Furusyo N, Nakamura M, et al. Glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C genotype 1 or 2 infection: Results from a multicenter, real-world cohort study. Hepatol Res 2019; 49: 617-626 – reference: 6) Nozaki A, Atsukawa M, Kondo C, et al. The effectiveness and safety of glecaprevir / pibrentasvir in chronic hepatitis C patients with refractory factors in the real world: a comprehensive analysis of a prospective multicenter study. Hepatol Int 2020; 14: 225-238 – reference: 11) Meissner E, Bon D, Prokunina-Olsson P, et al. IFNL4-DG genotype is associated with slower viral clearance in hepatitis C, genotype-1 patients treated with sofosbuvir and ribavirin. J Infect Dis 2014; 209: 1700-1704 – reference: 4) Sezaki H, Suzuki F, Hosaka T, et al. Initial- and re-treatment effectiveness of glecaprevir and pibrentasvir for Japanese patients with chronic hepatitis C virus-genotype 1/2/3 infections. J Gastroenterol 2019; 54: 916-927 – reference: 2) Toyoda H, Chayama K, Suzuki F, et al. Efficacy and safety of glecaprevir/pibrentasvir in Japanese patients with chronic genotype 2 hepatitis C virus infection. Hepatology 2017; 67: 505-513 – reference: 13) Drafting Committee for Hepatitis Management Guidelines, the Japan Society of Hepatology. Japan Society of Hepatology guidelines for the management of hepatitis C virus infection: 2019 update. Hepatol Res 2020; 50: 791-816 |
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| Title | Glecaprevir/pibrentasvir治療不成功であったGenotype 2型症例に対しglecaprevir/pibrentasvir再治療を行った2症例 |
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