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Reactivation of hepatitis C virus with severe hepatitis flare during steroid administration for interstitial pneumonia

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Abstract

Hepatitis C virus reactivation (HCVr) was defined previously as an increase in HCV RNA level of ≥ 1 log10 IU/mL from baseline HCV RNA level after chemotherapies or immunosuppressive therapies, but HCVr during a steroid monotherapy has rarely been reported. Here we report a 75-year-old Japanese female with chronic hepatitis C (genotype 2a) who developed HCVr after the administration of prednisolone for interstitial pneumonia. She experienced alanine aminotransferase (ALT) flare with icterus, but after the tapering of prednisolone and a liver supporting therapy, levels of HCV RNA and ALT were gradually decreased. Then, she received an anti-viral therapy with sofosbuvir/ledipasvir. Although HCV relapsed 4 weeks after the therapy, a second therapy with glecaprevir/pibrentasvir was successful. This case suggests that HCVr with hepatitis flare can occur even after a steroid monotherapy, and we should pay attention to HCVr when we administer prednisolone for patients with HCV chronic infection.

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Authors and Affiliations

  1. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Kosuke Sato, Jun Inoue, Eiji Kakazu, Masashi Ninomiya, Tomoaki Iwata, Akitoshi Sano, Mio Tsuruoka & Atsushi Masamune

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  1. Kosuke Sato
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  2. Jun Inoue
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  3. Eiji Kakazu
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  4. Masashi Ninomiya
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  5. Tomoaki Iwata
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  6. Akitoshi Sano
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  7. Mio Tsuruoka
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  8. Atsushi Masamune
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Correspondence to Jun Inoue.

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Conflict of interest

JI received research grants from Gilead Sciences and AbbVie GK. The other authors state that they have no conflict of interest.

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Sato, K., Inoue, J., Kakazu, E. et al. Reactivation of hepatitis C virus with severe hepatitis flare during steroid administration for interstitial pneumonia. Clin J Gastroenterol 14, 1221–1226 (2021). https://doi.org/10.1007/s12328-021-01432-4

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  • DOI: https://doi.org/10.1007/s12328-021-01432-4

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