Treatment of chronic hepatitis C virus infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy tube in a patient with HIV coinfection

Author:

Huffman Vanessa1,Andrade Diana C1,Sherman Elizabeth23,Niu Jianli4,Eckardt Paula A2

Affiliation:

1. Department of Pharmacy, Memorial Hospital West, Memorial Healthcare System, Pembroke Pines, FL

2. Division of Infectious Disease, Memorial Regional Hospital, Memorial Healthcare System, Hollywood, FL

3. College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL

4. Office of Human Research, Memorial Healthcare System, Hollywood, FL

Abstract

Abstract Purpose Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. Summary This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. Conclusion Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.

Publisher

Oxford University Press (OUP)

Subject

Health Policy,Pharmacology

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