title: Achievement of sustained viral response after switching treatment from pegylated interferon α-2b to α-2a and ribavirin in patients with recurrence of hepatitis C virus genotype 1 infection after liver transplantation: a case report.
abstract: We report a case in which sustained viral response was achieved after switching treatment from pegylated interferon (PEG-IFN) α-2b to α-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 α-2b and RBV for 2 years, and later developed hepatocellular carcinoma (HCC). After surgical resection of HCC, he subsequently received PEG-IFN α-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 α-2b and RBV. However, breakthrough viremia occurred. PEG-IFN was thus switched from α-2b to α-2a and RBV for another 17 months. The patient eventually achieved a sustained viral response.
authors.affiliation: Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hiraga
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Katamura
authors.forename: Daiki
authors.initials: D
authors.lastname: Miki
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Koji
authors.initials: K
authors.lastname: Waki
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ochi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D019943:Amino Acid Substitution; D000998:Antiviral Agents / Q000008:administration & dosage*; D004358:Drug Therapy / Q000379:methods; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012367:RNA, Viral / Q000235:genetics; D011994:Recombinant Proteins / Q000008:administration & dosage; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage*; D017384:Sequence Deletion; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a