Hepatitis C Virus Clearance after Discontinuation of Pegylated Interferon Alpha-2a Monotherapy in a Child

Abstract EN

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 μg/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.