Page 226 - Read Online

Douhara et al. DAA therapy for patients with CHC

Before DAA

2
（mL/min/1.73 m ）
（IU/L） SOF + LDV Renal biopsy SVR 24 （Log/mL）
12 weeks
190 7

160 6
5
130 ALT Normal chest
eGFR 4
100 After SVR 24
HCV-RNA
3
2
40 1

10 0
Feb-16 Jun-16 Oct-16

BHL
Figure 3: A case of sarcoidosis after DAA treatment. A 46-year-old male. After the end of DAA treatment, renal dysfunction occurred.
Renal biopsy revealed renal sarcoidosis. Moreover, chest X-P showed BHL while the ophthalmologic examination showed iritis. The
eradication of HCV or the DAA treatment itself might have triggered the onset of sarcoidosis. DAA: direct-acting antiviral; BHL: bilateral
hilar lymphadenopathy; HCV: hepatic C virus; SOF: sofosbuvir; LDV: ledipasvir; SVR: sustained virological response

CHA

（ng/mL） （Log/mL）
（IU/L） TACE 1st TACE 2nd TACE 3rd
300 SVR 24 8
SOF + LDV 7
250
12 weeks
6
200
5 ALT CHA angiography showed
multiple HCC (arrow)
150 4 AFP
HCV-RNA
3
100
2
50
1
0 0
May-15 Aug-15 Nov-15 Feb-15 May-16 Aug-15 Nov-15

3rd C-TACE was performed
Figure 4: A case of HCC development after DAA treatment. A 81-year-old male. Before the start of DAA treatment, TACE was
performed twice. Then, DAA treatment was initiated after a complete response was achieved. CE-CT after 3 months from the end of
DAA treatment showed local and distant HCC recurrence. CHA angiography showed multiple HCC. Thus, a 3rd TACE was performed
for HCC recurrence. HCC: hepatocellular carcinoma; DAA: direct-acting antiviral; TACE: transarterial chemoembolization; CT: computed
tomography; SOF: sofosbuvir; LDV: ledipasvir; ALT: alanine aminotransferase; AFP: alpha-fetoprotein; HCV: hepatic C virus; SVR:
sustained virological response
218 Hepatoma Research ¦ Volume 3 ¦ October 17, 2017