Successful treatment of fibrosing cholestatic hepatitis with pegylated interferon, ribavirin and sofosbuvir after a combined kidney-liver transplantation

Transpl Int. 2015 Feb;28(2):255-8. doi: 10.1111/tri.12428. Epub 2014 Sep 29.

Abstract

Fibrosing cholestatic hepatitis (FCH) is a classical but rare and severe form of recurrent hepatitis C virus (HCV) after liver transplantation. Classical anti-HCV therapy, that is pegylated-interferon (peg-interferon) and ribavirin, has been shown to have limited efficacy in treating FCH. Herein, we report on the first case of successful use of peg-interferon, ribavirin, plus sofosbuvir to treat HCV-induced FCH in a combined liver-kidney transplant patient. Antiviral therapy was given for 24 weeks. HCV clearance occurred within 4 weeks after starting therapy and was maintained until 4 weeks after the end of therapy. Antiviral tolerance was good. We conclude that the use of sofosbuvir-based anti-HCV therapy can be successfully used to treat FCH after a liver or combined kidney-liver transplantation.

Keywords: fibrosing cholestatic hepatitis; hepatitis C virus; kidney transplantation; liver transplantation; sofosbuvir.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiviral Agents / administration & dosage*
  • Drug Combinations
  • Hepatitis C / drug therapy*
  • Humans
  • Interferon-alpha / administration & dosage
  • Kidney Transplantation / adverse effects*
  • Liver Transplantation / adverse effects*
  • Male
  • Polyethylene Glycols / administration & dosage
  • Recombinant Proteins / administration & dosage
  • Recurrence
  • Ribavirin / administration & dosage
  • Sofosbuvir
  • Uridine Monophosphate / administration & dosage
  • Uridine Monophosphate / analogs & derivatives

Substances

  • Antiviral Agents
  • Drug Combinations
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • Uridine Monophosphate
  • peginterferon alfa-2a
  • Sofosbuvir