Relapse of hepatitis C virus after 14 months of sustained virological response following pegylated-interferon alpha plus ribavirin therapy in a human immunodeficiency virus type 1 infected patient

J Clin Virol. 2013 Sep;58(1):309-14. doi: 10.1016/j.jcv.2013.05.009. Epub 2013 Jun 28.

Abstract

It has been demonstrated that sustained virological response (SVR) in patients with chronic hepatitis C indicates resolution of infection. We describe a late hepatitis C virus (HCV) relapse with nearly identical HCV genotype 1a RNA, 14 months after a SVR achievement following a 12-month pegylated-interferon plus ribavirin treatment in a human immunodeficiency virus (HIV) infected patient. This virological relapse occurred concomitantly with interruption of highly active antiretroviral therapy and subsequent increased immunosuppression. HCV retreatment was successful and HCV RNA was undetectable at 50 months of follow-up. This case suggests that late relapse of HCV infection in HIV-positive patients with SVR is possible in case of increased immunodeficiency related to highly active antiretroviral therapy interruption. In such circumstances, a close monitoring of HCV viremia and aminotransferases should be performed.

Keywords: HCV recurrence; HIV–HCV coinfection; Hepatitis C virus; Pegylated-interferon alpha plus ribavirin therapy.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Cluster Analysis
  • Genotype
  • HIV Infections / complications*
  • HIV Infections / virology
  • HIV-1 / isolation & purification
  • Hepacivirus / classification
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon-alpha / therapeutic use*
  • Male
  • Middle Aged
  • Phylogeny
  • RNA, Viral / genetics
  • Recurrence
  • Ribavirin / therapeutic use*
  • Sequence Analysis, DNA

Substances

  • Antiviral Agents
  • Interferon-alpha
  • RNA, Viral
  • Ribavirin