%0 Journal Article
%T Hepatitis C Virus Clearance after Discontinuation of Pegylated Interferon Alpha-2a Monotherapy in a Child
%A Takeshi Endo
%A Koichi Ito
%A Tokio Sugiura
%A Kenji Goto
%J Case Reports in Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/597348
%X The present patient was a 4-year-old boy. His hepatitis C virus genotype was 2a, and his viral load was high (1400,000£¿U/mL). The pretreatment liver biopsy revealed no fibrosis or malignancy and mild chronic hepatitis; his Knodell's histological activity (HAI) score was 4. Single nucleotide polymorphism of IL28B (rs8099917) was major type. The patient began antiviral treatment with pegylated interferon alpha 2a (90£¿¦̀g/week). At week 9, serum HCV RNA became undetectable, with a sensitivity of 50£¿copies/mL. Antiviral treatment was discontinued at week 11 because the ALT level increased to 610£¿U/L. After discontinuation of therapy, the patient¡¯s serum HCV RNA status became positive again. The serum viral load increased to 100,000£¿U/mL. During this period, he had been observed without medication. Sixteen months after stopping treatment, serum HCV became undetectable. Over a 4-year period, HCV RNA became negative and his anti-HCV antibody titer gradually decreased. In conclusion, though antiviral therapy resulted in failure or incomplete therapy, a reduced viral load resulted in viral clearance in the present patient. Interleukin 28B genotype might have association with the clearance of hepatitis C virus after discontinuation of antiviral therapy. 1. Introduction About 70% of hepatitis C virus (HCV) infections lead to chronic liver disease, and chronic HCV infection leads to cirrhosis and hepatocellular carcinoma. Recently, antiviral therapy, such as pegylated interferon (PEG-IFN) and ribavirin, has been successful in more than 50% of infected patients, resulting in clearance of HCV RNA from the serum. It has been assumed that patients infrequently or never achieve elimination of chronic HCV infection without receiving antiviral treatment. Recent studies indicate that there is a relationship between rs8099917 TT interleukin (IL) 28B genotype and HCV treatment response in adults [1]. However, the IL28B genotype influences in HCV infection among children have been a little investigated. We report the case of a boy with viral clearance after discontinuation of PEG-IFN ¦Á2a monotherapy because of elevated transaminase levels. IL28 genotyping was performed in this patient. 2. Case Presentation A 2-year-old boy was referred to our hospital due to chronic hepatitis C infection. Markers of hepatitis A virus, hepatitis B virus, cytomegalovirus, and human immunodeficiency virus were negative. Tests for hepatitis E, and Epstein-Barr viruses were not performed. Autoantibody titers were not high, and serum IgG was within the normal range. The possibility of autoimmune
%U http://www.hindawi.com/journals/crim/2012/597348/