一名接受肝移植的患者在使用聚乙二醇干扰素和利巴韦林治疗丙型肝炎复发期间发生急性乙型肝炎。

Acute hepatitis B in a patient with OLT during treatment with peg-interferon and ribavirin for hepatitis C recurrence.

作者信息

Biliotti Elisa, Zacharia Sabu, Grieco Stefania, Spaziante Martina, Giusto Michela, Merli Manuela, Gallinaro Valentina, Taliani Gloria

机构信息

Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.

出版信息

J Chemother. 2012 Dec;24(6):369-72. doi: 10.1179/1973947812Y.0000000046.

DOI:10.1179/1973947812Y.0000000046

PMID:23174103

Abstract

The course and outcome of acute viral hepatitis in liver transplanted patients with hepatitis C recurrence are unknown. Here we describe a patient who presented with acute hepatitis B infection while on treatment with peg-interferon and ribavirin for hepatitis C recurrence after liver transplantation. A nucleoside analogue was added (entecavir) and the patient cleared hepatitis C virus (HCV) infection and seroconverted to anti-HBs. In this case, the acute hepatitis B virus (HBV) infection might have contributed to the clearance of HCV, the concomitant immunosuppression might have lead to the slow clearance of HBV infection, and the combined antiviral therapy has helped in the resolution of both infections. Hepatitis B vaccination should be recommended in susceptible patients waiting for liver transplantation.

摘要

肝移植后丙型肝炎复发患者急性病毒性肝炎的病程和转归尚不清楚。在此，我们描述了一名肝移植后丙型肝炎复发患者，在接受聚乙二醇干扰素和利巴韦林治疗时出现急性乙型肝炎感染。添加了一种核苷类似物（恩替卡韦）后，患者清除了丙型肝炎病毒（HCV）感染并血清转化为抗-HBs。在该病例中，急性乙型肝炎病毒（HBV）感染可能有助于HCV的清除，同时存在的免疫抑制可能导致HBV感染清除缓慢，联合抗病毒治疗有助于两种感染的消退。对于等待肝移植的易感患者，应建议接种乙型肝炎疫苗。