A case of acute liver dysfunction without elevation of ALT caused by treatment with daclatasvir and asunaprevir

Abstract

A 65-year-old female with hepatitis C (genotype 1b) was started on a planned 24-week course of daclatasvir (DCV) and asunaprevir (ASV) treatment. She was a treatment-naïve case of anti-hepatitis C virus (HCV). She was estimated to be interferon-intolerant. At 11 days after starting treatment, she had a high fever, slight elevation in total bilirubin, and prolonged prothrombin time. However, there was no elevation of AST or ALT. Additionally, she developed ascites after starting treatment, and her blood test results indicated eosinophilia and high levels of serum immunoglobulin E and C-reactive protein. The DCV_ASV therapy was discontinued at 17 days after starting treatment; after discontinuation of therapy, her fever resolved and her hepatic functional reserve improved.