Background: Direct-acting Antivirals (DAA) are currently used in the treatment of chronic
HCV infection. In patients with renal failure Glecaprevir/Pibrentasvir (genotype 1-6) is recommended
for its safety and efficacy.
Case Presentation: Although these pharmacological characteristics, an adverse drug reaction (ADR)
has been reported during Glecaprevir/Pibrentasvir treatment, such as the development of cholestatic
jaundice in an elderly patient with chronic HCV (genotype 2) infection. At examination, patient was
jaundiced associated with intense pruritus.
Results: Ultrasound and laboratory biochemical tests excluded a liver failure (e.g. liver cancer, and
liver lithiasis) or pancreatic cancer while Naranjo probability scale (score 6) suggested an association
between cholestatic jaundice and Glecaprevir/Pibrentasvir administration. About 1 month after drug
discontinuation, an improvement has been documented in both jaundice and pruritus, with a
normalization in bilirubin levels (total bilirubin: 0.96 mg/dL), HCV-RNA was undetected also. It is
worth mentioning that although we reported the development of cholestatic jaundice upon treatment
with Glecaprevir/Pibrentasvir we recorded a clinical efficacy (HCV-RNA <15 IU/L) after 4 weeks
from the beginning of the treatment, with a complete remission of clinical symptoms until 7 months
after drug discontinuation.
Conclusion: These data support the clinical efficacy of Glecaprevir/Pibrentasvir association in elderly
patients, despite the sub-optimal period of treatment.