COVID-19 After Treatment With Direct-acting Antivirals for HCV Infection and Decompensated Cirrhosis: A Case Report

Chikako Ikegami, Tatsuo Kanda, Tomotaka Ishii, Masayuki Honda, Yoichiro Yamana, Reina Sasaki Tanaka, Mariko Kumagawa, Shini Kanezawa, Taku Mizutani, Hiroaki Yamagami, Naoki Matsumoto, Ryota Masuzaki, Kentaro Hayashi, Kazushige Nirei, Tadateru Takayama, Mitsuhiko Moriyama

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Eradication of hepatitis C virus (HCV) from chronic HCV-infected patients could improve liver function and prevent hepatocarcinogenesis in the long term. Eradication of HCV by direct-acting antivirals (DAAs) also leads to dynamic immunological changes. We report a case of recurrent coronavirus disease 2019 (COVID-19) that developed immediately after combination treatment with DAAs for HCV infection and decompensated cirrhosis. Case Report: A 55-year-old male was started on a 12-week treatment with combination of HCV NS5A inhibitor velpatasvir and HCV NS5B polymerase inhibitor sofosbuvir. HCV RNA became undetectable after six weeks of treatment and was undetectable at the end of the treatment (EOT). Twelve days after the EOT, we diagnosed the patient with COVID-19 pneumonia, admitted him to our hospital and he was discharged two weeks later. One week after his discharge, he visited our hospital again, was diagnosed with recurrent COVID-19 pneumonia readmitted for a second time. Four days after second admission, cardiac arrest occurred, however, he recovered from severe COVID-19 and achieved sustained virological response and his liver function improved. Conclusion: In the COVID-19 era, while attention should be paid to the occurrence or exacerbation of infection, including COVID-19, interferon-free DAA combination therapy should be performed for HCV-infected individuals.

Original languageEnglish
Pages (from-to)1986-1993
Number of pages8
JournalIn vivo (Athens, Greece)
Issue number4
Publication statusPublished - Jul 2022


  • COVID-19
  • SARS-CoV-2
  • SVR
  • decompensated cirrhosis


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