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

We report a case in which sustained viral response was achieved after switching treatment from pegylated interferon (PEG-IFN) alpha-2b to alpha-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) IL28B single nucleotide polymorphisms (rs8099917). He had initially received interferon alpha-2b and RBV for 2 years, and later developed hepatocellular carcinoma (HCC). After surgical resection of HCC, he subsequently received PEG-IFN alpha-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 alpha-2b and RBV. However, breakthrough viremia occurred. PEG-IFN was thus switched from alpha-2b to alpha-2a and RBV for another 17 months. The patient eventually achieved a sustained viral response. Copyright (C) 2011 S. Karger AG, Basel