Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 1009-1013
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.1009
Simeprevir with peginterferon and ribavirin induced interstitial pneumonitis: First case report
Katsuyoshi Tamaki, Akihiko Okubo
Katsuyoshi Tamaki, Department of Hepatology, Tourai-kai Okubo Hospital, Tokushima 770-0923, Japan
Akihiko Okubo, Department of Respirology, Tourai-kai Okubo Hospital, Tokushima 770-0923, Japan
Author contributions: Tamaki K and Okubo A equally contributed to this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Katsuyoshi Tamaki, MD, PhD, Department of Hepatology, Tourai-kai Okubo Hospital, 2-30 Omichi, Tokushima 770-0923, Japan. cer.tamaki@gmail.com
Telephone: +81-88-6229156 Fax: +81-88-6229157
Received: May 9, 2014
Peer-review started: May 10, 2014
First decision: June 10, 2014
Revised: June 23, 2014
Accepted: July 22, 2014
Article in press: July 22, 2014
Published online: January 21, 2015
Processing time: 256 Days and 0.6 Hours
Abstract

The effectiveness of hepatitis C treatment has improved with the development of interferon (IFN), and it has drastically improved with the development of peg-interferon-α (PEG-IFN) in combination with ribavirin (RBV) and, more recently, with the addition of a protease inhibitor. Simeprevir, which is a second-generation protease inhibitor, has shown clinically favorable safety and tolerability profiles. Simeprevir received its first global approval in Japan in September 2013 for the treatment of genotype 1 chronic hepatitis C in combination with PEG-IFN and RBV. One serious adverse event associated with IFN therapy is interstitial pneumonitis, which can be fatal. We experienced a patient with interstitial pneumonitis that was induced by simeprevir with PEG-IFN and RBV therapy for chronic hepatitis C in the early stages of therapy (8 wk after initiating therapy). This is the first case report of interstitial pneumonitis with simeprevir with PEG-IFN and RBV in the world. In addition, it is very interesting that the onset of interstitial pneumonitis was earlier than that in conventional PEG-IFN and RBV therapy. This finding suggests that simeprevir augments the adverse event. We present this case report in light of relevant literature on interstitial pneumonitis with conventional PEG-IFN and RBV therapy.

Keywords: Simeprevir; Chronic hepatitis C; Interstitial pneumonitis; Peg-interferon-α; Adverse events

Core tip: Simeprevir is recently being used as a protease inhibitor for hepatitis C. Several reports have indicated that simeprevir has clinically favorable safety and tolerability profiles. However, this is the first report of interstitial pneumonitis that was induced by simeprevir with peg-interferon and ribavirin therapy for chronic hepatitis C. Therefore, it is necessary to carefully observe the presence of respiratory symptoms in patients receiving this treatment.