Disappearance of serum HCV-RNA after short-term prednisolone therapy in a patient with chronic hepatitis C associated with autoimmune hepatitis-like serological manifestations

J Gastroenterol. 1999 Apr;34(2):269-74. doi: 10.1007/s005350050256.

Abstract

We report a 70-year-old woman with chronic hepatitis C associated with autoimmune hepatitis (AIH)-like serological manifestations, in whom elimination of hepatitis C virus (HCV) was observed after corticosteroid treatment. The patient was infected with HCV, genotype Ib, but had several laboratory findings, such as markedly elevated serum gamma-globulin and IgG, characteristic of AIH, as well as a high titer of an anti-nuclear antibody. An ultrasound (US)-guided liver biopsy disclosed chronic active hepatitis F3. Corticosteroid worsened her liver function test results and raised amounts of HCV-RNA in the serum. Withdrawal of the corticosteroid led to prompt normalization of transaminase levels and the disappearance of serum HCV-RNA, determined by reverse transcription-polymerase chain reaction (RT-PCR). For 4 years, up to the time of this study, her transaminase values have been normal and HCV viremia was not detected by repeated RT-PCR. We believe this to be the first reported case in which eradication of HCV was achieved by corticosteroid therapy alone, without the introduction of interferon.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Female
  • Hepacivirus / isolation & purification*
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / pathology
  • Hepatitis, Autoimmune / blood*
  • Hepatitis, Autoimmune / complications
  • Hepatitis, Autoimmune / pathology
  • Humans
  • Prednisolone / therapeutic use*
  • RNA, Viral / blood*
  • Serologic Tests
  • Viremia / drug therapy

Substances

  • RNA, Viral
  • Prednisolone