Y with tenofovir was straight away began and after 5 days, the prothrombin concentration became normal, but ALT and bilirubin remained enhanced. Conclusions NAs Galanthamine therapy should be continued until HBs seroconversion, even in individuals who achieved undetectable VL. The risk of extreme liver decompensation particularly in young individuals is extremely high. In ladies with childbearing potential, ETV can be switched with tenofovir plus the therapy has to be continued during the whole pregnancy. Consent Written informed consent was obtained in the patients for publication of this Case report and any accompanying photos. A copy of the written consent is readily available for critique by the Editor of this journal.A34 The dynamic of hematological problems during direct acting antivirals therapy for HCV compensated cirrhosis Cristina Popescu1,2, Cristina Murariu1, Cristina Dragomirescu1, Anca Leutean1, Laureniu Stratan1, Alina Orfanu1,2, Alexandra Badea1, Remulus Catan1,2, Anca Negru1,2, Ctlin Tilican1,two, Daniela Munteanu1,2, Mihaela Rdulescu1,two, Violeta Molagic1,two, Raluca Mihaela Nstase1, Ioan Alexandru Diaconu1,two, Iulia Bodoca1, Violeta Ni1, Victoria Aram1,two 1 National Institute for Infectious Ailments “Prof. Dr. Matei Bal”, Bucharest, Romania; 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Correspondence: Cristina Murariu ([email protected]) BMC Infectious Diseases 2016, 16(Suppl four):A34 Background The regimen authorized in Romania for the sufferers with HCV a0023781 compensated cirrhosis involves Ombitasvir-Paritaprevir/Ritonavir-Dasabuvir (OPrD) in association with ribavirin. By far the most critical side impact, during ribavirin primarily based therapy, is anemia, well-known in the era of Peginterferon-ribavirin regimen. Objective: to analyze the hematological issues occurred for the duration of OPrD ?ribavirin therapeutic regimen for HCV compensated cirrhosis. Techniques Prospective study in the HCV cirrhotic individuals treated with OPrDribavirin regimen from November 2015 until July 2016 in Third Department of Matei Bal Institute which analyzed the dynamic of hemoglobin level and platelet count during 12 weeks of DAA therapy. Results Eighty-seven sufferers with HCV compensated cirrhosis were treated in our department. The mean age was 61.93 years old and sex ratio F:M = 1.12:1. Right after 1 month of therapy, 19 patients (21.83 ) created moderate anemia with hemoglobin below 11 g/dL (involving 7.eight g/dL and 10.8 g/dL, using a medium value of 9.8 g/dL). Sixteen of those sufferers permanently discontinued ribavirin throughout very first month of antiviral therapy and two patients permanently discontinued all therapeutic regimen: one particular patient for serious cardiac disturbances plus the other for liver decompensation with vital jaundice. For other 3 patients the dosage of ribavirin was decreased. For 20 patients, hemoglobin level following 1st month of therapy was in between 11 and 12 g/dL (mild anemia ?22.98 ) and due to severe fatigue, the dosage of ribavirin was lowered. Soon after 2 months of therapy from 81 individuals who reached this endpoint, other 7 sufferers permanently discontinued ribavirin resulting from moderate anemia (under 11 g/dL). 37/67 (55.22 ) of sufferers who completed the therapy had anemia despite the reduction or discontinuation of ribavirin. 37 individuals completed the monitoring therapy (SVR12) and each of the sufferers who developed anemia had regular amount of hemoglobin. With regards to thrombocytopenia, it was enhanced through jir.2012.0140 antiviral therapy.