Zhong JL, Zhao LW, Chen YH, Luo YW. Acute-on-chronic liver failure induced by antiviral therapy for chronic hepatitis C: A case report. World J Clin Cases 2023; 11(30): 7463-7468 [PMID: 37969459 DOI: 10.12998/wjcc.v11.i30.7463]
Corresponding Author of This Article
Ya-Wen Luo, PhD, Chief Doctor, Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563000, Guizhou Province, China. luoyw719@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Clin Cases. Oct 26, 2023; 11(30): 7463-7468 Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7463
Acute-on-chronic liver failure induced by antiviral therapy for chronic hepatitis C: A case report
Jiang-Li Zhong, Ling-Wei Zhao, Ying-Hua Chen, Ya-Wen Luo
Jiang-Li Zhong, Ying-Hua Chen, Ya-Wen Luo, Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Ling-Wei Zhao, Department of Hematology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Author contributions: Zhong JL contributed to manuscript writing and editing, and data collection; Zhao LW contributed to data analysis; Chen YH and Luo YW contributed to supervision; all authors have read and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 82160558; and Zunyi Science and Technology Fund.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Wen Luo, PhD, Chief Doctor, Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563000, Guizhou Province, China. luoyw719@163.com
Received: July 31, 2023 Peer-review started: July 31, 2023 First decision: August 17, 2023 Revised: August 30, 2023 Accepted: September 26, 2023 Article in press: September 26, 2023 Published online: October 26, 2023
Abstract
BACKGROUND
There have been no reports of acute-on-chronic liver failure (ACLF) during treatment of chronic hepatitis C (CHC) with direct-acting antivirals (DAAs).
CASE SUMMARY
We report a 50-year-old male patient with CHC. The patient sought medical attention from the Department of Infectious Diseases at our hospital due to severe yellowing of the skin and sclera, which developed 3 mo previously and attended two consecutive hospitals without finding the cause of liver damage. It was not until 1 mo ago that he was diagnosed with CHC at our hospital. After discharge, he was treated with DAAs. During treatment, ACLF occurred, and timely measures such as liver protection, enzyme lowering, anti-infective treatment, and suppression of inflammatory storms were implemented to control the condition.
CONCLUSION
DAA drugs significantly improve the cure rate of CHC. However, when patients have factors such as autoimmune attack, coinfection, or unclear hepatitis C virus genotype, close monitoring is required during DAA treatment.
Core Tip: The advent of direct-acting antivirals (DAAs) for chronic hepatitis C (CHC) has improved the rate of sustained virology response, resulting in clinical cure of CHC. We report a rare case of CHC where the patient developed acute-on-chronic liver failure during DAA therapy. Based on comprehensive analysis, the genotype of hepatitis C virus in this patient was unclear, and he was in an autoimmune hyperimmune state at the time and was coinfected with bacteria. When CHC is combined with the above conditions, close monitoring should be carried out during treatment to avoid a poor prognosis.
