CASE STUDY:
Retreatment of HCV Treatment Relapser

CLINICAL INFORMATION

HISTORY OF PRESENT ILLNESS

A 63-year-old Caucasian man presented to a hepatology clinic seeking advice regarding a diagnosis of chronic hepatitis C (HCV) genotype 1b. The original diagnosis of HCV infection was made in October 1996 while undergoing a routine annual physical. His only symptom at that time was mild fatigue. In 1998, the patient was initially treated with interferon (IFN) α-2b (3 million units TIW) and ribavirin (RBV; 1200 mg/day) for 48 weeks. He finished the therapy with an undetectable HCV RNA. However, HCV RNA was detected again at 24 weeks posttherapy. In 2001, the patient was re-treated with peginterferon α-2a (180 µg/week) and ribavirin (1200 mg/day) for 48 weeks. Again, he finished the therapy with an undetectable HCV RNA. However, HCV RNA was once again detected at 24 weeks posttherapy. During HCV antiviral treatments, the patient experienced worsening fatigue and moderate depression that required antidepressant therapy (trazodone). In addition, during therapy with peginterferon α-2a and ribavirin, he experienced episodes of shortness of breath related to bronchitis, and his hypertension was difficult to manage.