Hepatitis C treatment with triple therapy in a patient with hemophilia A

摘要

We report a case of successful treatment of chronic hepatitis C infection with telaprevir-based triple therapy in a patient with hemophilia A complicated by factorⅧinhibitor.A twenty-two years old male with hereditary hemophilia A and high-titer factorⅧinhibitor was taking maintenance doses of recombinant factorⅧ.He visited our clinic for treatment of his chronic hepatitis C with the newly instituted protease inhibitor based therapy.He was diagnosed with hepatitis C genotype 1a at one year of age.He was initiated on telaprevir,ribavirin and peg-interferon for treatment of hepatitis C and qualified for response-guided therapy.He completed treatment at 24 wk with minimal adverse effects.Notably,after 4 wk of hepatitis C treatment,his factorⅧinhibitor screen was negative and the dose for recombinant factorⅧdecreased by half of the initial dosing before he was treated for hepatitis C.We suspect that suppressing hepatitis C may help decrease factorⅧinhibitor level and the need for recombinant factorⅧ.