Article ID Journal Published Year Pages File Type
3265750 Digestive and Liver Disease 2009 5 Pages PDF
Abstract

BackgroundThe recurrence of hepatitis C after liver transplantation is extremely frequent. Antiviral therapy combining pegylated-interferon with ribavirin is therefore increasingly used in these patients. It has been recently reported, however, that during antiviral treatment a hepatic immune-mediated liver dysfunction, similar to “de novo” autoimmune hepatitis, may develop in a few transplanted patients.Patients and methodsThree patients, treated with pegylated-interferon α-2a and ribavirin for recurrent hepatitis C after liver transplantation, developed an aggressive hepatitis with clinical, biochemical, and histological features similar to those of autoimmune hepatitis.ResultsIn all three patients, a liver enzymes increase was evident after hepatitis C virus-RNA had become undetectable. Diagnosis of “de novo” autoimmune hepatitis was proposed, based on the presence of high-titre circulating autoantibodies and liver histology features. Following the introduction of a steroid therapy, clinical and biochemical parameters progressively improved. Hepatitis C virus infection, however, relapsed after a few months in all the patients.ConclusionsFollowing liver transplantation, antiviral therapy with pegylated-interferon α-2a and ribavirin for recurrent hepatitis C may be associated, in a few patients, with severe immune-mediated graft dysfunction similar to autoimmune hepatitis.

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