title: Fatal Relapse of Myelodysplastic Syndrome in a Patient with HIV/Hepatitis C Coinfection Treated with Simeprevir/Sofosbuvir.
abstract: Registrational studies and observational cohorts clearly suggest sustained virologic response (SVR) rates in HIV-/hepatitis C-coinfected patients are similar to monoinfected patients when utilizing interferon-free regimens, and this can be accomplished with agents that are well tolerated with minimal adverse events. These randomized trials that led to the approval of several of our new direct-acting antiviral agents, however, specifically excluded patients who had significant comorbidities and none to our knowledge accepted patients with a history of cancer. Therefore, the effect of treatment of active hepatitis C in such patients and the effect on preexisting neoplasia are relatively unknown. We prospectively followed a 62-year-old male coinfected with HIV/hepatitis C who had a history of anal squamous cell carcinoma, prostate carcinoma, renal cell carcinoma all clinically cured and a myelodysplastic syndrome that was in remission. The patient achieved an SVR of hepatitis C with simeprevir/sofosbuvir without ribavirin and died shortly thereafter of a fatal relapse of his previously clinically controlled myelodysplastic syndrome.
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Efemena Michael
authors.initials: EM
authors.lastname: Diejomaoh
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Joseph Clayton
authors.initials: JC
authors.lastname: Gathe
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Carl Craig
authors.initials: CC
authors.lastname: Mayberry
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: John Benjamin
authors.initials: JB
authors.lastname: Clemmons
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Bernie
authors.initials: B
authors.lastname: Miguel
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Glombicki
authors.affiliation: 1 Therapeutic Concepts, Cure C Consortium, Houston, TX, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Daquioag
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications*; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use; D000069616:Simeprevir / Q000627:therapeutic use*; D000069474:Sofosbuvir / Q000627:therapeutic use*; D000072230:Sustained Virologic Response
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: HIV/hepatitis C; SVR-12; myelodysplastic syndrome; ribavirin; simeprevir/sofosbuvir