Spontaneous clearance of HCV accompanying hepatitis after liver transplantation

Clinical Journal of Gastroenterology
Tomomi KogisoKatsutoshi Tokushige

Abstract

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 disco...Continue Reading

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Citations

Jan 20, 2016·Gastroenterology·Nicolas Goossens, Yujin Hoshida
Jun 4, 2016·Transplant International : Official Journal of the European Society for Organ Transplantation·Robert J De Knegt
Dec 12, 2017·Journal of Clinical and Translational Hepatology·George CholankerilAparna Goel
Feb 3, 2018·World Journal of Gastroenterology : WJG·Chiranjeevi GadiparthiAijaz Ahmed

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