Long-term administration of cyclosporin A to HCV-antibody-positive patients with dermatologic diseases

Background Cyclosporine A (CYA) is an immunosuppressive agent which is bein g used in the treatment of an increasingly wide range of dermatologic disea ses, but its use has been avoided in carriers of hepatitis C virus (HCV). Methods We administered small doses of CYA (maximum, 3 mg/kg/day) for a lon g time to treat dermatologic diseases in one HCV-antibody-positive patient with no HCV-RNA in the blood, one patient with a small amount of HCV-RNA in the blood, and two patients with large amounts of HCV-RNA in the blood. Results Skin lesions improved in all patients, but recurred upon complete o r partial withdrawal of CYA. In the absence of HCV-RNA in the blood, or whe n only a small quantity of HCV-RNA was present in the blood, HCV-RNA load s howed no apparent change. In one patient with a large blood HCV-RNA load, C YA dosage reduction was followed by increases in alanine aminotransferase ( ALT) levels and decreases in blood HCV-RNA. Aggravation of hepatitis due to immunologic reactivation was suspected in this patient. Conclusions The reduction of CYA dosage is a key element in the use of this agent for cutaneous diseases.