1Immunodeficiency Clinic, University Health Network, Toronto, Canada. Electronic address: firstname.lastname@example.org.
A rare side effect of ledipasvir/sofosbuvir is liver injury, which occurs within 2-6 weeks of starting treatment. Total and direct bilirubin values are greatly increased, and worsening of liver function may occur; symptoms are usually reversible when treatment is stopped. An interaction with lopinavir/ritonavir may contribute to this adverse effect.