Sofosbuvir as post-exposure prophylaxis for yellow fever–associated viscerotropic disease (YEL-AVD).

This article focuses on the use of sofosbuvir, an NS5B nucleotide inhibitor, as post-exposure prophylaxis for yellow fever–associated viscerotropic disease (YEL-AVD), a rare but severe complication of live-attenuated yellow fever vaccination in individuals with risk factors such as thymectomy. It presents a case of a 30-year-old man who received the yellow fever vaccine despite prior thymectomy and was treated with a 14-day course of oral sofosbuvir, resulting in no development of YEL-AVD symptoms and no adverse effects. Given the lack of established treatments and high fatality rates associated with YEL-AVD, this case supports the potential safety and utility of sofosbuvir in high-risk patients, although definitive efficacy remains to be confirmed by ongoing studies. The report emphasizes multidisciplinary decision-making and careful outpatient monitoring in managing such cases.