title: Disappearance of serum HCV-RNA after short-term prednisolone therapy in a patient with chronic hepatitis C associated with autoimmune hepatitis-like serological manifestations.
abstract: We report a 70-year-old woman with chronic hepatitis C associated with autoimmune hepatitis (AIH)-like serological manifestations, in whom elimination of hepatitis C virus (HCV) was observed after corticosteroid treatment. The patient was infected with HCV, genotype Ib, but had several laboratory findings, such as markedly elevated serum gamma-globulin and IgG, characteristic of AIH, as well as a high titer of an anti-nuclear antibody. An ultrasound (US)-guided liver biopsy disclosed chronic active hepatitis F3. Corticosteroid worsened her liver function test results and raised amounts of HCV-RNA in the serum. Withdrawal of the corticosteroid led to prompt normalization of transaminase levels and the disappearance of serum HCV-RNA, determined by reverse transcription-polymerase chain reaction (RT-PCR). For 4 years, up to the time of this study, her transaminase values have been normal and HCV viremia was not detected by repeated RT-PCR. We believe this to be the first reported case in which eradication of HCV was achieved by corticosteroid therapy alone, without the introduction of interferon.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: M
authors.initials: M
authors.lastname: Toyohara
authors.forename: Y
authors.initials: Y
authors.lastname: Yamane
authors.forename: M
authors.initials: M
authors.lastname: Mimura
authors.forename: Y
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: S
authors.initials: S
authors.lastname: Ueda
authors.forename: H
authors.initials: H
authors.lastname: Kawamoto
authors.forename: H
authors.initials: H
authors.lastname: Fukui
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: E
authors.initials: E
authors.lastname: Hayashi
authors.forename: A
authors.initials: A
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D001706:Biopsy; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood*; D012698:Serologic Tests; D014766:Viremia / Q000188:drug therapy
chemical_list: D012367:RNA, Viral; D011239:Prednisolone