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Liver injury, myopathy and rhabdomyolysis: case report A 63-year-old woman developed rhabdomyolysis following interaction of paritaprevir and ritonavir with simvastatin. Additionally, she developed idiosyncratic liver injury during treatment with dasabuvir, ombitasvir, paritaprevir and ritonavir [routes and dosages not stated]. The woman, who had chronic chronic hepatitis C and dyslipidemia, started receiving ombitasvir, paritaprevir, ritonavir and dasabuvir for 12 weeks. Eleven days after treatment, she developed severe weakness and muscle rigidity. Antiviral therapy was discontinued. On 13-day, the woman presented to the emergency department following worsening of muscle rigidity. Laboratory investigations revealed creatinine kinase (CK) of 8690 U/L, AST of 759 U/L and ALT of 457 U/L. She was hospitalised with the diagnosis of rhabdomyolysis, myopathy and antiviral-induced idiosyncratic liver injury. The woman was treated with fluid resuscitation. On further evaluation, she recalled that she had been receiving concomitant therapy with simvastatin for the past few weeks. Simvastatin was discontinued, and CK, AST and ALT levels showed gradual improvement. Eventually, she was discharged. After 30 days of treatment initiation, lab tests showed normalisation of CK, AST and ALT levels. Yardeni D, et al. Sustained virological response following an 11-day course of direct acting antiviral therapy for hepatitis c infection. Journal of Gastrointestinal and Liver 803499801 Diseases 29: 272, No. 2, Jun 2020. Available from: URL: http://doi.org/10.15403/jgld-2153

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