title: Ombitasvir, paritaprevir, ritonavir, dasabuvir and ribavirin in cirrhosis after complete destruction of hepatocellular carcinoma.
abstract: We observed a sustained viral response (SVR) of ombitasvir/paritaprevir/ritonavir, dasabuvir and ribavirin therapy, for 12 wk, in two cases with compensated liver cirrhosis and fully destroyed early hepatocellular carcinoma (HCC). Patients were infected with hepatitis C virus (HCV) genotype 1b and were previous null responders/relapsers to interferon-alpha/ribavirin (IFN/RBV). There was a rapid suppression of HCV RNA to undetectable levels within the first two treatment weeks. SVR was achieved even after marked reduction of the RBV dose. The treatment was well tolerated. Both subjects experienced worsening of liver disease during therapy, in different patterns: severe, transient, predominantly direct hyperbilirubinemia without cytolysis (case 1) or progressive increase of aminotransferases (grade 4) without severe hyperbilirubinemia (case 2). Adverse events spontaneously resolved. The patients remained in a good clinical condition without hepatic decompensation. There was no re-occurrence of HCC. This is the first report for treatment of HCV cirrhosis after complete HCC destruction.
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Zahariy
authors.initials: Z
authors.lastname: Krastev
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Deian
authors.initials: D
authors.lastname: Jelev
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Krasimir
authors.initials: K
authors.lastname: Antonov
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Tanya
authors.initials: T
authors.lastname: Petkova
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Evelina
authors.initials: E
authors.lastname: Atanasova
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Nadezhda
authors.initials: N
authors.lastname: Zheleva
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Bojidar
authors.initials: B
authors.lastname: Tomov
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Yana
authors.initials: Y
authors.lastname: Boyanova
authors.affiliation: Zahariy Krastev, Deian Jelev, Krasimir Antonov, Tanya Petkova, Evelina Atanasova, Nadezhda Zheleva, Bojidar Tomov, Yana Boyanova, Lyudmila Mateva, Clinic of Gastroenterology, University Hospital "St. Ivan Rilski", 1431 Sofia, Bulgaria.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Mateva
mesh_terms: D015081:2-Naphthylamine; D000368:Aged; D000813:Anilides / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D002219:Carbamates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D047029:Lactams, Macrocyclic; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D047028:Macrocyclic Compounds / Q000627:therapeutic use*; D008297:Male; D011392:Proline / Q000031:analogs & derivatives; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012254:Ribavirin / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014498:Uracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014633:Valine; D019562:Viral Load
chemical_list: D000813:Anilides; D000998:Antiviral Agents; D002219:Carbamates; D003521:Cyclopropanes; D047029:Lactams, Macrocyclic; D047028:Macrocyclic Compounds; D012367:RNA, Viral; D013449:Sulfonamides; C586094:ombitasvir; D012254:Ribavirin; D014498:Uracil; D011392:Proline; D015081:2-Naphthylamine; C588260:dasabuvir; D014633:Valine; D019438:Ritonavir; C585405:paritaprevir
keywords: Dasabuvir; Hepatitis C virus cirrhosis; Hepatocellular carcinoma; Ombitasvir; Paritaprevir; Ribavirin; Ritonavir