Disappearance of serum HCV-RNA after short-term prednisolone therapy in a patient with chronic hepatitis C associated with autoimmune hepatitis-like serological manifestations.
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.
Yoshikawa
M
M
Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
Toyohara
M
M
Yamane
Y
Y
Mimura
M
M
Miyamoto
Y
Y
Ueda
S
S
Kawamoto
H
H
Fukui
H
H
Kobayashi
T
T
Hayashi
E
E
Nakamura
A
A
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
D012367:RNA, Viral; D011239:Prednisolone