Background Rapid graft dysfunction caused by hepatitis C virus (HCV) reinfe
ction, although uncommon, is a disastrous complication in liver transplant
patients, Finding an effective therapy for this subgroup of patients with s
evere recurrent HCV is a priority.
Method. We describe a successful rescue of a 46-year-old man with recurrent
hepatitis C (HCV genotype 1b) using long-term interferon (IFN) and ribavir
in. The patient had a very aggressive type of posttransplantation HCV infec
tion, as judged by biochemical and histologic findings.
Results. Despite high pretreatment values of serum alanine aminotransferase
(ALT; peak value of 901 IU/L), and HCV-RNA (2.3 x 10(6) copies/ml), the co
mbination therapy with IFN and ribavirin produced a rapid normalization of
the serum ALT values, accompanied by the clearance of serum HCV-RNA. Althou
gh HCV-RNA reappeared in the serum at 3 months, the patient had continued A
LT normalization and histological improvement with follow-up of over 26 mon
ths to date after the initiation of the combination therapy.
Conclusion. This observation suggests that IFN in combination with ribaviri
n may offer an effective therapeutic option for liver transplant patients w
ith severe recurrent hepatitis C.