Achievement of Sustained Viral Response after Switching Treatment from Pegylated Interferon alpha-2b to alpha-2a and Ribavirin in Patients with Recurrence of Hepatitis C Virus Genotype 1 Infection after Liver Transplantation : A Case Report
Achievement of Sustained Viral Response after Switching Treatment from Pegylated Interferon alpha-2b to alpha-2a and Ribavirin in Patients with Recurrence of Hepatitis C Virus Genotype 1 Infection after Liver Transplantation : A Case Report
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肝移植后丙型肝炎病毒基因型 1 感染复发患者从聚乙二醇干扰素 α-2b 转为 α-2a 和利巴韦林治疗后获得持续病毒缓解：病例报告
DOI：
10.1159/000328661
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Chayama K
中科院分区：
文献类型：
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作者：
Kawaoka T;Hiraga N;Takahashi S;Takaki S;Tsuge M;Nagaoki Y;Hashimoto Y;Katamura Y;Muki D;Hiramatsu A;Waki K;Imamura M;Kawakami Y;Aikata H;Ochi H;Tashiro H;Ohdan H;Chayama K
我们报告了一例活体肝移植术后丙型肝炎病毒（HCV）感染复发的患者，在从聚乙二醇干扰素（PEG-IFN）α-2b转换为α-2a和利巴韦林（RBV）治疗后获得持续病毒应答的病例。患者是一名62岁男性，因HCV基因型1b感染而患有肝硬化。该患者在干扰素敏感性决定区有8个氨基酸（aa）取代，在核心区分别在aa 70和aa 91处有突变型和野生型取代。该患者具有次要基因型（GG）IL 28 B单核苷酸多态性（rs 8099917）。他最初接受干扰素α-2b和RBV治疗2年，后来发展为肝细胞癌（HCC）。在手术切除HCC后，他随后接受PEG-IFN α-2b和RBV治疗1.5年，在治疗过程中没有检测到病毒血症。由于HCC复发，患者接受了活体肝移植。后来，丙型肝炎复发。为了控制复发，他接受了另一个疗程的PEG-IFN α-2b和RBV。然而，发生了突破性病毒血症。因此，PEG-IFN从α-2b转换为α-2a和RBV，持续17个月。患者最终获得了持续的病毒应答。
We report a case in which sustained viral response was achieved after switching treatment from pegylated interferon (PEG-IFN) α-2b to α-2a and ribavirin (RBV) in patients with recurrence of hepatitis C virus (HCV) infection after living donor liver transplantation. The patient was a 62-year-old man with liver cirrhosis due to HCV genotype 1b infection. The patient had 8 amino acid (aa) substitutions in the interferon sensitivity-determining region, and had substitutions for mutant and wild-type at aa70 and aa91, respectively, in the core region. The patient had minor genotype (GG)IL28Bsingle nucleotide polymorphisms (rs8099917). He had initially received interferon α-2b and RBV for 2 years, and later developed hepatocellular carcinoma (HCC). After surgical resection of HCC, he subsequently received PEG-IFN α-2b and RBV for 1.5 years, without undetectable viremia during the treatment course. Due to recurrence of HCC, the patient received a living donor liver transplantation. Later on, hepatitis C relapsed. For the management of relapse, he received another course of PEG-IFN α-2b and RBV. However, breakthrough viremia occurred. PEG-IFN was thus switched from α-2b to α-2a and RBV for another 17 months. The patient eventually achieved a sustained viral response.