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Daclatasvir and asunaprevir for recurrent hepatitis C following living donor liver transplantation with HIV co‐infection

Antiviral treatment in liver transplant recipients co‐infected with hepatitis C virus (HCV) and HIV remains a challenge. We herein report a case of HCV recurrence that was successfully treated using interferon‐free anti‐HCV therapy with daclatasvir and asunaprevir. A 48‐year‐old man underwent antiviral therapy with a 24‐week course of daclatasvir and asunaprevir for biopsy‐proven recurrent HCV 15 months after living donor liver transplantation, following non‐response to pre‐emptive antiviral treatment with pegylated interferon plus ribavirin. Anti‐HIV and immunosuppressive regimens were modified safely. Renal function was feasibly preserved. The anti‐HCV effect was remarkable with an undetectable viral load confirmed within 2 weeks, and this patient achieved a sustained virological response after 12 weeks of post‐transplantation treatment. No serious adverse events were observed. This case indicates that daclatasvir and asunaprevir for recurrent HCV in a HIV co‐infected recipient after liver transplantation is safe and effective.