title: Drug induced hypersensitivity syndrome by triple therapy of peginterferon alpha2b, ribavirin and telaprevir in patient with double positive for HBV and HCV.
abstract: Sixty year-old male positive for both HCV-RNA and HBsAg was treated by triple therapy of peginterferon alpha2b, ribavirin and telaprevir. Eight weeks after the beginning of the therapy, the patient developed drug induced hypersensitivity syndrome (DIHS) with general erythema multiforme and 64 times anti-HHV6 antibody elevation. Sixty milligram of prednisolone was administered with gradual dose reduction and the skin lesion was improved. HBV-DNA and transaminase elevated one week after the steroid induction and entecavir improved them. DIHS itself and the aggravation of hepatitis B by corticosteroid should be kept in mind in cases with dual infection of HBV and HCV treated by antivirals including telaprevir.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hoshino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Naganuma
authors.forename: Eri
authors.initials: E
authors.lastname: Koitabashi
authors.forename: Sanae
authors.initials: S
authors.lastname: Uehara
authors.forename: Naomi
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kudo
authors.forename: Keiichirou
authors.initials: K
authors.lastname: Ryusaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Kakizaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D060085:Coinfection; D004279:DNA, Viral / Q000097:blood; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D005938:Glucocorticoids; D006514:Hepatitis B Surface Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C413685:entecavir; D006147:Guanine; C486464:telaprevir; D011239:Prednisolone; C417083:peginterferon alfa-2b