トリイ　ノブユキ   Torii Nobuyuki   鳥居　信之    所属   医学部 医学科（附属成人医学センター）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読なし
表題	Spontaneous clearance of HCV accompanying hepatitis after liver transplantation.
掲載誌名	正式名：Clinical journal of gastroenterology 略　 称：Clin J Gastroenterol ISSNコード：(1865-7265)1865-7265(Linking)
掲載区分	国外
巻・号・頁	8(5),pp.323-329
著者・共著者	KOGISO Tomomi, HASHIMOTO Etsuko, IKARASHI Yuichi, KODAMA Kazuhisa, TANIAI Makiko, TORII Nobuyuki, EGAWA Hiroto, YAMAMOTO Masakazu, TOKUSHIGE Katsutoshi
発行年月	2015/10
概要	Re-infection by the hepatitis C virus (HCV) occurs rapidly after liver transplantation (LT), and spontaneous clearance of HCV is rare under immunosuppressive conditions. Here, we report on two patients who underwent LT to treat liver cirrhosis and hepatocellular carcinoma. The immunosuppressants prescribed were short-term corticosteroids, tacrolimus, and mycophenolate mofetil. A 50-year-old woman underwent LT, with her brother as the donor. She acquired HCV of serological type 1 after LT; the HCV RNA level was 6.0 logIU/mL. Corticosteroids were discontinued within 24 days, with a total dose of 669 mg (adjusted) prednisolone (PSL). The serum alanine aminotransferase (ALT) level increased to 700 U/L by day 55 post-LT. Surprisingly, HCV RNA was not detected on day 87. A 52-year-old man underwent LT, with his sister as the donor. He became rapidly re-infected with HCV of serological type 2; the HCV RNA level was 6.9 logIU/mL. Corticosteroids were given for 24 days, with a total dose of 827 mg (adjusted) PSL. The serum ALT level increased continuously and his HCV cleared 115 days after LT. Both donor and recipient had the major IL28B genotype. HCV was eliminated spontaneously, even under immunosuppressive conditions, after PSL discontinuation without interferon treatment. Minimal use of immunosuppressants and the presence of hepatitis may have contributed to HCV clearance. However, it is important to evaluate additional relevant cases.
DOI	10.1007/s12328-015-0602-y
PMID	26342292