Ineffective Absorption? Failure of Direct-Acting Therapy for Chronic Hepatitis C in Cirrhotic Patients With Roux-en-Y Gastric Bypass

Clara Y. Tow, John F. Reinus

Research output: Contribution to journalArticle

Abstract

In this era of direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection, treated patients have extremely high rates of sustained virologic response to short courses of therapy regardless of stage of fibrosis. Treatment failure is uncommon and often attributed to medication noncompliance or viral resistance to drug. This report describes 2 Child-Pugh-A cirrhotic patients who failed to clear HCV in response to therapy with DAAs. Each patient had Roux-en-Y gastric bypass (RYGB) surgery preceding DAA therapy. RYGB may create multiple barriers to adequate DAA absorption as a result of changes in gastrointestinal physiology. Treatment monitoring and duration should be carefully considered in this unique patient population.

Original languageEnglish (US)
JournalJournal of Investigative Medicine High Impact Case Reports
Volume7
DOIs
StatePublished - Jun 1 2019
Externally publishedYes

Fingerprint

Gastric Bypass
Chronic Hepatitis C
Viruses
contagious disease
Physiology
Antiviral Agents
Surgery
Hepacivirus
Viral Drug Resistance
Monitoring
physiology
Therapeutics
Medication Adherence
surgery
Virus Diseases
Treatment Failure
medication
monitoring
drug
Fibrosis

Keywords

  • cirrhosis
  • direct-acting antiviral
  • gastric bypass
  • hepatitis C virus
  • Roux-en-Y

ASJC Scopus subject areas

  • Epidemiology
  • Safety, Risk, Reliability and Quality
  • Safety Research

Cite this

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