Peginterferon-α-2b/ribavirin
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Reactions 1014 - 14 Aug 2004 S Peginterferon-α-2b/ribavirin Liver decompensation: case report A 36-year-old female liver transplant recipient developed liver decompensation during peginterferon-α/ribavirin therapy for recurrent hepatitis C virus infection. Six months post-transplantation, the woman started treatment with peginterferon-α-2b 96 µg/week and ribavirin 800 mg/day; her concomitant medication included tacrolimus. One month later, she developed massive ascites, jaundice and renal failure. Peginterferon-α-2b and ribavirin were discontinued. Laboratory investigations revealed ALT and AST levels of 42 and 58 IU/L, respectively, a direct bilirubin level of 2.9 mg/dL, a prothrombin time of 18.6 seconds, an INR of 1.8, an albumin level of 2.4 g/dL, a creatinine level of 6.1 mg/dL and a urine sodium level of < 5 mmol/L. An ultrasound revealed ascites with patent portal vein and hepatic vessels, and she had a serum albumin-ascites albumin gradient of > 1.1. After 2 months of aggressive medical management, her ascites resolved completely and her prothrombin time, bilirubin, albumin and creatinine levels normalised, although her transaminase levels remained elevated. Author comment: "The temporal association between the initiation of combination therapy and the development of decompensated liver disease, together with its resolution after drug discontinuation, are strongly suggestive of a causal relationship." Mukherjee S. Reversible decompensated liver disease as a possible complication of pegylated - interferon alfa 2b and ribavirin for recurrent hepatitis C. Journal of Gastroenterology and Hepatology 19: 723-724, No. 6, Jun 2004 - USA 800982605 1 Reactions 14 Aug 2004 No. 1014 0114-9954/10/1014-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Peginterferon-α-2b/ribavirin
Reactions 1014 - 14 Aug 2004
SPeginterferon-α-2b/ribavirin
Liver decompensation: case reportA 36-year-old female liver transplant recipient developed
liver decompensation during peginterferon-α/ribavirin therapyfor recurrent hepatitis C virus infection.
Six months post-transplantation, the woman startedtreatment with peginterferon-α-2b 96 µg/week and ribavirin800 mg/day; her concomitant medication included tacrolimus.One month later, she developed massive ascites, jaundice andrenal failure.
Peginterferon-α-2b and ribavirin were discontinued.Laboratory investigations revealed ALT and AST levels of 42and 58 IU/L, respectively, a direct bilirubin level of 2.9 mg/dL, aprothrombin time of 18.6 seconds, an INR of 1.8, an albuminlevel of 2.4 g/dL, a creatinine level of 6.1 mg/dL and a urinesodium level of < 5 mmol/L. An ultrasound revealed asciteswith patent portal vein and hepatic vessels, and she had aserum albumin-ascites albumin gradient of > 1.1. After2 months of aggressive medical management, her ascitesresolved completely and her prothrombin time, bilirubin,albumin and creatinine levels normalised, although hertransaminase levels remained elevated.
Author comment: "The temporal association between theinitiation of combination therapy and the development ofdecompensated liver disease, together with its resolution afterdrug discontinuation, are strongly suggestive of a causalrelationship."Mukherjee S. Reversible decompensated liver disease as a possible complication ofpegylated - interferon alfa 2b and ribavirin for recurrent hepatitis C. Journal ofGastroenterology and Hepatology 19: 723-724, No. 6, Jun 2004 -USA 800982605
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Reactions 14 Aug 2004 No. 10140114-9954/10/1014-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
