2014, Number 5
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Ann Hepatol 2014; 13 (5)
Antimitochondrial antibody serocoversion post-liver transplant during hepatitis C treatment with peginterferon α, ribavirin and telaprevir
Marquez-Azalgara V, Hussaini T, Erb SR, Yoshida EM
Language: English
References: 9
Page: 565-567
PDF size: 69.54 Kb.
ABSTRACT
Pegylated interferon alpha (PEG-IFN α), a key component of chronic hepatitis C therapy, has been linked
to the development of auto-antibodies and autoimmune disease. We report the first case of antimitochondrial
antibody (AMA) seroconversion during PEG-INF α based therapy after liver. transplantation. A fiftyseven
year-old man five months after liver transplantation was initiated on hepatitis C triple therapy with
PEG-INF α, ribavirin and telaprevir. He had failed previous PEG-IFN α and ribavirin 12 years pre-transplant
and his AMA remained negative pre-transplant. After twelve weeks of antiviral therapy, he developed elevated
liver enzyme tests associated with an AMA seroconversion to seropositivity. A liver biopsy failed to
show histological evidence of primary biliary cirrhosis or graft rejection. He was initiated on urseodeoxycholic
acid with subsequent improvement of his liver enzymes. This case demonstrates that despite adequate
immunosuppression, AMA seroconversion may occur post-transplant during interferon-based
therapy. As AMA seroconversion did not occur during the pre-transplant PEG-IFN therapy, we speculate
that donor allograft antigens in combination with PEG-IFN may have been a factor in the post-transplant
seroconversion.
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