Articles
CASE REPORT
A Case Report of Alloimmune Hepatitis after Direct-acting Antiviral Treatment in a Liver Transplant Patient
Catherine Choi1, Youssef Botros2, Jamil Shah3, Pei Xue4, Anja Jones5, Mark Galan5, Raquel Olivo6, Mumtaz Niazi6, Flavio Paterno7, James Guarrera7 and Nikolaos T. Pyrsopoulos*,6
1 Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
2 Division of Gastroenterology, St. Joseph’s University Medical Center, Paterson, NJ, USA
3 Division of Gastroenterology & Hepatology, The Brooklyn Hospital Center, Brooklyn, NY, USA
4 Rutgers New Jersey Medical School, Newark, NJ, USA
5 Department of Pathology, Immunology & Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
6 Division of Gastroenterology & Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
7 Division of Liver Transplantation & Hepatobiliary Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
*Correspondence to: Nikolaos T. Pyrsopoulos, Division of Gastroenterology & Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Medical Science Building, Room I-506, 185 South Orange Avenue, Newark, NJ 07103, USA. Tel: +1-973-972-5252, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Journal of Clinical and Translational Hepatology 2020;8(4):459-462 DOI: 10.14218/JCTH.2020.00062
Received: July 7, 2020 Accepted: August 24, 2020 Published online: October 10, 2020
Abstract
Direct-acting antiviral (DAA) therapy is often well-tolerated, and adverse events from DAA therapy are uncommon. We report a case of a woman who underwent orthotopic liver transplant for chronic hepatitis C infection and later developed alloimmune hepatitis shortly after starting DAA therapy for recurrent hepatitis C infection. The patient developed acute alloimmune hepatitis approximately 2 weeks after starting treatment with sofosbuvir, velpatasvir, and voxilaprevir. This case report proposes a dysregulation of immune surveillance due to the DAA stimulation of host immunity and rapid elimination of hepatitis C viral load as a precipitating factor for the alloimmune process, leading to alloimmune hepatitis in a post-transplant patient who starts on DAA.
Keywords
Autoimmune hepatitis, Hepatitis C, Liver transplant
Journal of Clinical and Translational Hepatology 2020 vol. 8, 459-462 [ Html ] [ PDF Full-text ]
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