Postpartum acute exacerbation of chronic hepatitis C with complete response to interferon-alpha.
We describe a patient with chronic hepatitis C who had severe postpartum acute exacerbation of the disease, with marked aminotransferase elevations and jaundice. The viral genotype was 2a, and the patient had a low viral load. Neither superinfection with another hepatotropic virus nor autoantibodies were evident. Markedly increased serum concentrations of T-helper (Th) 1-type cytokines and cytokine receptors, including interleukin (IL)-8, tumor necrosis factor (TNF)-alpha, soluble TNF receptor (sTNFR)-p55, sTNFR-p75, and soluble Fas antigen (sFas), as well as that of the Th 2-type cytokine, IL-10, were present. Complete biochemical and virologic response was achieved with interferon (IFN)-alpha treatment, which decreased cytokine elevations while favoring Th 1 dominance. Acute exacerbation of hepatitis C may occur when cellular immune responses are activated, as in late pregnancy and in the postpartum period. Treating such acute exacerbations immediately with IFN may be highly efficacious.
Oketani
Makoto
M
The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Shibatou
Toshihiko
T
Yamashita
Katsuhisa
K
Arima
Takushi
T
Arima
Terukatsu
T
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000628:therapy*; D006801:Humans; D007111:Immunity, Cellular; D016898:Interferon-alpha / Q000097:blood / Q000627:therapeutic use*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000628:therapy*; D018121:Receptors, Cytokine / Q000097:blood; D019014:fas Receptor / Q000097:blood
D016898:Interferon-alpha; D018121:Receptors, Cytokine; D019014:fas Receptor; D000410:Alanine Transaminase; D001663:Bilirubin