The patient was a 72-year-old woman with a history of surgery for pulmonary tuberculosis at 19 years of age. She had no history of allergies, smoking, or drinking consumption. Her height was 154 cm, weight 44 kg, and BMI 18.5 kg/m2. Her HCV genotype was 1b, and she had not previously received treatment for HCV infection. She was found to have compensated cirrhosis: 23.3 kPa on Fibroscan testing, a Child-Pugh score of class A5, and a HCV RNA level of 6.8 log IU/mL. She had no comorbidities and had been taking only an oral ursodeoxycholic acid agent. Her laboratory test results were as follows: albumin 3.7 g/dL, total bilirubin 0.37 mg/dL, AST 60 IU/L, ALT 44 IU/L, ALP 578 IU/L, LDH 260 IU/L, total cholesterol 132 mg/dL, triglyceride 68 mg/dL, and blood glucose 101 mg/dL (Table 1). The hepatitis B virus test result was negative. The ECG QTc ratio was 430 mm, and there was no evidence of premature ventricular contractions (VPcs).
SOF (400 mg) and LDV (90 mg) were administered. Two days later, ECG monitoring showed VT, although the patient remained asymptomatic. The VT resolved spontaneously. However, 5 days later, ECG monitoring detected a similar episode of VT.
LDV/SOF was discontinued after consultation with a cardiologist. The patient had no specific symptoms during the VT episodes. Her cardiac function was assessed using a standard ECG, echocardiogram, Holter monitoring, and heart rate monitoring; the results were unremarkable. She was discharged from the hospital 20 days after admission (Fig. 2).