A 50-year-old man weighing 79 kg with HCV cirrhosis (genotype 1b/fibroscan 22.6 KPa) diagnosed 20 years ago, with splenomegaly, portal hypertension and leukothrombocytopenia. History of injecting drug addiction with no methadone substitution treatment at present. In 2009, treatment with interferon was ineffective. Other medical and family history of no relevance.
In July 2015 he started treatment with Viekirax®, Exviera® and Rebetol®, 1,200 mg per day for 12 weeks, without any concomitant treatment. Two weeks later, she went to the doctor and reported good tolerance. By the fourth week, the viral load was negative, but the patient reported skin lesions, a change in character, aggressiveness and suicidal thoughts, so both he and his family asked to discontinue treatment and he was referred to psychiatry.
In December 2015, the patient came to the clinic with a report from Psychiatry stating that he had not been prescribed any psychopharmaceuticals and that at that time there was no contraindication to starting another HCV treatment. In February 2016, treatment was started with ledipasvir 90 mg/sofosbuvir 400 mg (Harvoni®) and Rebetol® 1,200 mg for 12 weeks. At the fourth week, the patient reported good tolerance and the viral load was negative. At the twelfth week, the patient successfully completed the treatment.