Two cases of chronic hepatitis C with sustained virological response in whom serum HCV RNA reappeared two or twelve years after the end of IFN treatment

Abstract

We experienced two cases of chronic hepatitis C with sustained virological response (SVR) in whom HCV RNA reappeared after the end of IFN treatment. Case 1 was a 54-year-old man with HCV/2a, who achieved SVR by IFN-α2b for 26 weeks. Twelve years later, his ALT level flared up and HCV/2a reemerged temporally, accompanied by a marked increase of anti-C22 antibody. Case 2 was a 68-year-old man with HCV/1b, who achieved SVR by IFN-β for 2 weeks and IFN-α2b/Ribavirin for 22 weeks After 26 months HCV/1b reappeared and continued to be positive without an elevation of ALT. Pairwise comparison and phylogenetic analysis within the NS5B 1,087-nucleotide sequence revealed that the HCV isolates obtained at the time points of pretreatment and reemergence shared 99.3% identity and are virtually the same strains. These results suggest that SVR patients have a potential risk for HCV reactivation even 12 years after the end of therapy. © 2006 The Japan Society of Hepatology.