2019 Volume 60 Issue 12 Pages 459-465
A 48-year-old man was referred to our hospital for nivolumab administration for the treatment of unresectable squamous cell carcinoma of the lung. He had hepatitis C virus infection with virus genotype type 2a and was not treated with antiviral therapy with interferon or direct-acting antivirals. Nivolumab was administered three times every 2 weeks. The serum transaminase levels increased 2 weeks after the third administration. At first, drug-induced liver injury due to nivolumab was suspected; however, liver biopsy revealed acute exacerbation of chronic hepatitis C (new Inuyama classification, F1/A2). A 12-week combination therapy of sofosbuvir and ribavirin was initiated. The serum transaminase levels improved, and a sustained virological response was obtained 24 weeks after the completion of antiviral therapy. No subsequent transaminase elevation has been observed.
