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. 2021 Aug;14(4):1221-1226.
doi: 10.1007/s12328-021-01432-4. Epub 2021 May 13.

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

Kosuke Sato  1 , Jun Inoue  2 , Eiji Kakazu  1 , Masashi Ninomiya  1 , Tomoaki Iwata  1 , Akitoshi Sano  1 , Mio Tsuruoka  1 , Atsushi Masamune  1
Affiliations

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

Kosuke Sato et al. Clin J Gastroenterol. 2021 Aug.

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.

Keywords: Direct acting antivirals; HCV reactivation; Prednisolone.

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