Interferon alpha 2B and ribavirin in severe recurrent cholestatic hepatitis C

Severe recurrent cholestatic hepatitis C after Liver transplantation has a poor prognosis and no standard therapy is currently available. Four cases o f severe recurrent cholestatic hepatitis C treated with a combination of in terferon alpha 2b and ribavirin are described. All four patients were trans planted for hepatitis C-related cirrhosis. The mean age at transplantation was 45 years (range 41-51 years). Three of the patients were male and one w as female. Ah four patients had hepatitis C virus viremia before and after liver transplantation. At 2 to 23 months after liver transplantation, all f our patients developed jaundice, cholestatic elevation of Liver enzymes, an d histopathology consistent with severe recurrent cholestatic hepatitis C. Combination of interferon and ribavirin was given with prompt virological s uppression. Despite this rapid viral suppression, all four patients develop ed progressive graft failure with three deaths.