Abstract BACKGROUND: The recurrence of hepatitis C after liver transplantation is extremely frequent. Antiviral therapy combining pegylated-interferon with ribavirin is therefore increasingly used in these patients. It has been recently reported, however, that during antiviral treatment a hepatic immune-mediated liver dysfunction, similar to "de novo" autoimmune hepatitis, may develop in a few transplanted patients. PATIENTS AND METHODS: Three patients, treated with pegylated-interferon alpha-2a and ribavirin for recurrent hepatitis C after liver transplantation, developed an aggressive hepatitis with clinical, biochemical, and histological features similar to those of autoimmune hepatitis. RESULTS: In all three patients, a liver enzymes increase was evident after hepatitis C virus-RNA had become undetectable. Diagnosis of "de novo" autoimmune hepatitis was proposed, based on the presence of high-titre circulating autoantibodies and liver histology features. Following the introduction of a steroid therapy, clinical and biochemical parameters progressively improved. Hepatitis C virus infection, however, relapsed after a few months in all the patients. CONCLUSIONS: Following liver transplantation, antiviral therapy with pegylated-interferon alpha-2a and ribavirin for recurrent hepatitis C may be associated, in a few patients, with severe immune-mediated graft dysfunction similar to autoimmune hepatitis.

Immune-mediated liver dysfunction after antiviral treatment in liver transplanted patients with hepatitis c: Allo or autoimmune de novo hepatitis? / Merli, Manuela; Gentili, Federica; Giusto, Michela; Attili, Adolfo Francesco; GINANNI CORRADINI, Stefano; Mennini, Gianluca; Rossi, Massimo; Corsi, Alessandro; Bianco, Paolo. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - STAMPA. - 41:5(2009), pp. 345-349. [10.1016/j.dld.2008.09.015]

Immune-mediated liver dysfunction after antiviral treatment in liver transplanted patients with hepatitis c: Allo or autoimmune de novo hepatitis?

MERLI, Manuela;GENTILI, Federica;GIUSTO, MICHELA;ATTILI, Adolfo Francesco;GINANNI CORRADINI, Stefano;MENNINI, Gianluca;ROSSI, MASSIMO;CORSI, ALESSANDRO;BIANCO, Paolo
2009

Abstract

Abstract BACKGROUND: The recurrence of hepatitis C after liver transplantation is extremely frequent. Antiviral therapy combining pegylated-interferon with ribavirin is therefore increasingly used in these patients. It has been recently reported, however, that during antiviral treatment a hepatic immune-mediated liver dysfunction, similar to "de novo" autoimmune hepatitis, may develop in a few transplanted patients. PATIENTS AND METHODS: Three patients, treated with pegylated-interferon alpha-2a and ribavirin for recurrent hepatitis C after liver transplantation, developed an aggressive hepatitis with clinical, biochemical, and histological features similar to those of autoimmune hepatitis. RESULTS: In all three patients, a liver enzymes increase was evident after hepatitis C virus-RNA had become undetectable. Diagnosis of "de novo" autoimmune hepatitis was proposed, based on the presence of high-titre circulating autoantibodies and liver histology features. Following the introduction of a steroid therapy, clinical and biochemical parameters progressively improved. Hepatitis C virus infection, however, relapsed after a few months in all the patients. CONCLUSIONS: Following liver transplantation, antiviral therapy with pegylated-interferon alpha-2a and ribavirin for recurrent hepatitis C may be associated, in a few patients, with severe immune-mediated graft dysfunction similar to autoimmune hepatitis.
2009
autoimmune hepatitis; hepatitis hcv; liver transplantation
01 Pubblicazione su rivista::01a Articolo in rivista
Immune-mediated liver dysfunction after antiviral treatment in liver transplanted patients with hepatitis c: Allo or autoimmune de novo hepatitis? / Merli, Manuela; Gentili, Federica; Giusto, Michela; Attili, Adolfo Francesco; GINANNI CORRADINI, Stefano; Mennini, Gianluca; Rossi, Massimo; Corsi, Alessandro; Bianco, Paolo. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - STAMPA. - 41:5(2009), pp. 345-349. [10.1016/j.dld.2008.09.015]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/408287
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