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Relapse of hepatitis C in a pegylated‐interferon‐α‐2b plus ribavirin‐treated sustained virological responder
Author(s) -
Fujii Hideki,
Itoh Yoshito,
Ohnishi Naoki,
Sakamoto Masafumi,
Ohkawara Tohru,
Sawa Yoshihiko,
Nishida Koichi,
Nishimura Takeshi,
Yamaguchi Kanji,
Yasui Kohichiroh,
Minami Masahito,
Okanoue Takeshi,
Ohkawara Yasuo,
Yoshikawa Toshikazu
Publication year - 2010
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2010.00641.x
Subject(s) - ribavirin , medicine , pegylated interferon , discontinuation , gastroenterology , hepatitis c virus , hepatitis c , interferon , immunology , alanine transaminase , virology , virus
A 41‐year‐old woman with chronic hepatitis C was treated with pegylated‐interferon (PEG‐IFN)‐α‐2b plus ribavirin for 24 weeks. She had hepatitis C virus (HCV) genotype 2a (1600 KIU/mL), and her liver histology showed mild inflammation and fibrosis. Four weeks after the start of the therapy, she achieved a rapid virological response (RVR) and then a sustained virological response (SVR). Serum alanine aminotransferase (ALT) levels remained within normal ranges and HCV RNA continued to be negative. However, ALT levels flared with the re‐emergence of HCV RNA in the serum 1.5 years after discontinuation of therapy. HCV RNA obtained from sera before therapy and after relapse shared a 98.6% homology with the E2 region, and phylogenetic analyses indicated that they were the same HCV strain. These results eliminated the possibility of a re‐infection and strongly indicated a late relapse of the disease. Therefore, follow‐up is necessary for chronic hepatitis C patients after SVR, even if they respond well to therapy, including RVR.