Ledipasvir/Sofosbuvir for the treatment of hepatitis C in sickle-cell anemia


10 patients with sickle-cell anemia and hepatitis C genotype 1 or 4 were treated with ledipasvir/sofosbuvir. One patient with cirrhosis received 24 weeks of therapy. The remaining 9 patients without cirrhosis were treated for 12 weeks. Only one patient did not achieve sustained viral response (SVR). This patient was likely non adherent during the first weeks of the study as plasma concentrations of the active drugs and metabolites were not measurable during the first 4 weeks. The treatment did not seem to affect the course of the sickle-cell anemia and treatment was generally well tolerated.

Moon et al. Clin Infect Dis 2017;65:864-866

Comment: Patients with sickle-cell anemia are at high risk of liver diseases as a result of multiple transfusions with iron overload and viral hepatitis. Many come from countries where testing for hepatitis C in blood donors may not have been universal or have started only recently and hepatitis C is common in this group. Though a small group, it is important to know that these patients can be treated successfully for hepatitis C.