Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Non peer reviewed
Title Spontaneous clearance of HCV accompanying hepatitis after liver transplantation.
Journal Formal name:Clinical journal of gastroenterology
Abbreviation:Clin J Gastroenterol
ISSN code:(1865-7265)1865-7265(Linking)
Domestic / ForeginForegin
Volume, Issue, Page 8(5),pp.323-329
Author and coauthor KOGISO Tomomi, HASHIMOTO Etsuko, IKARASHI Yuichi, KODAMA Kazuhisa, TANIAI Makiko, TORII Nobuyuki, EGAWA Hiroto, YAMAMOTO Masakazu, TOKUSHIGE Katsutoshi
Publication date 2015/10
Summary 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