title: Low-dose IL-2 therapy reduces HCV RNA and HBV DNA: case report.
abstract: BACKGROUND
  Patients with concomitant hepatitis C (HCV) and B (HBV) infection are difficult to treat due to lack of medicines that control these viral infections and the high risk of hepatocellular carcinoma. Currently, there are insufficient data regarding the therapeutic effect of interleukin-2 (IL-2) during chronic viral infection, but this cytokine has shown antineoplastic activity and may have also an antiviral effect.
  
  
  METHODS
  We present the case of a 44-year-old patient with hemophilia A, HBV and HCV related compensated liver cirrhosis (Child-Pugh A) with several zones in the liver, highly suspicious for hepatocellular carcinoma. The patient was treated with low-dose intermittent subcutaneous IL-2 immunotherapy, followed by standard therapy with pegasys and copegus. During 23 months' follow-up, no tumour progression occurred, and the patient remained in Child-Pugh A stage. The initial HCV and HBV loads were significant (538,207 IU/ml) and minimal (825 copies/ml), respectively. The patient was treated with intermittent subcutaneously applied low-dose IL-2 cycles for ten months. HBV DNA and HCV RNA were undetectable 3 months after the last IL-2 cycle. After cessation of IL-2 therapy, the patient received standard antiviral treatment with pegasys and copegus. Nine months later, a slight reactivation of viruses was observed: HBV DNA was 18,600 copies/ml and HCV RNA was 58 IU/ml. Twenty-three months after the last IL-2 treatment (at the time of writing), the patient is alive and in a good clinical condition.
  
  
  CONCLUSIONS
  The decrease of HBV and HCV nucleic acids during immunotherapy with IL-2 predicts a possible new therapeutic option for these chronic viral infections.
authors.affiliation: Clinic of Gastroenterology, St Ivan Rilski University Hospital, Ivan Geshov Bvd 15, Sofia, Postal Code 1431, Bulgaria. raditomova@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Tomova
authors.forename: K
authors.initials: K
authors.lastname: Antonov
authors.forename: A
authors.initials: A
authors.lastname: Ivanova
authors.forename: J J L
authors.initials: JJ
authors.lastname: Jacobs
authors.forename: J W
authors.initials: JW
authors.lastname: Koten
authors.forename: W
authors.initials: W
authors.lastname: Den Otter
authors.forename: Z
authors.initials: Z
authors.lastname: Krastev
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000235:genetics; D004305:Dose-Response Relationship, Drug; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy / Q000235:genetics; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000235:genetics; D012367:RNA, Viral / Q000235:genetics*; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2; D012367:RNA, Viral