Severe Liver Injury Associated with Glecaprevir Plus Pibrentasvir Therapy in a Patient with Treatment-naive Hepatitis C Virus Infection

A 49-year-old man underwent treatment with glecaprevir plus pibrentasvir (G/P) for chronic hepatitis C infection. Six weeks later, he was admitted to our hospital because of jaundice and fatigue with no accompanying skin rash. A laboratory examination and evaluation of the patient's history resulted in a diagnosis of acute liver injury. Discontinuation of G/P and a rigorous medical protocol, including plasma exchange and hemodiafiltration, successfully mitigated the liver damage. The patient was also found to be allergic to two drugs other than the G/P therapy. In such cases with a history of drug allergy, careful observation may be required to detect serious adverse events.

Automated summary

A 49-year-old man with chronic hepatitis C infection underwent treatment with glecaprevir plus pibrentasvir (G/P) and developed acute liver injury six weeks later, which was successfully mitigated by discontinuing the treatment and implementing rigorous medical protocols including plasma exchange and hemodiafiltration. It was also discovered that the patient had allergies to two other drugs, highlighting the importance of careful observation in such cases with a history of drug allergy.