Abstract
Sixty year-old male positive for both HCV-RNA and HBsAg was treated by triple therapy of peginterferon alpha2b, ribavirin and telaprevir. Eight weeks after the beginning of the therapy, the patient developed drug induced hypersensitivity syndrome (DIHS) with general erythema multiforme and 64 times anti-HHV6 antibody elevation. Sixty milligram of prednisolone was administered with gradual dose reduction and the skin lesion was improved. HBV-DNA and transaminase elevated one week after the steroid induction and entecavir improved them. DIHS itself and the aggravation of hepatitis B by corticosteroid should be kept in mind in cases with dual infection of HBV and HCV treated by antivirals including telaprevir.
MeSH terms
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Antiviral Agents / adverse effects*
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Biomarkers / blood
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Coinfection*
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DNA, Viral / blood
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Drug Hypersensitivity Syndrome / diagnosis
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Drug Hypersensitivity Syndrome / drug therapy
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Drug Hypersensitivity Syndrome / etiology*
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Drug Substitution
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Drug Therapy, Combination
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Glucocorticoids / administration & dosage
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Glucocorticoids / adverse effects
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Guanine / analogs & derivatives
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Guanine / therapeutic use
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Hepacivirus / drug effects
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Hepacivirus / genetics
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Hepatitis B / blood
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Hepatitis B / complications
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Hepatitis B / diagnosis
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Hepatitis B / drug therapy*
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Hepatitis B / virology
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Hepatitis B Surface Antigens / blood
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Hepatitis B virus / drug effects
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Hepatitis B virus / genetics
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Hepatitis B virus / immunology
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Hepatitis C / blood
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Hepatitis C / complications
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Hepatitis C / diagnosis
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Hepatitis C / drug therapy*
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Hepatitis C / mortality
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Humans
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Interferon alpha-2
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Interferon-alpha / therapeutic use*
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Male
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Middle Aged
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Oligopeptides / adverse effects*
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Polyethylene Glycols / therapeutic use*
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Prednisolone / administration & dosage
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Prednisolone / adverse effects
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RNA, Viral / blood
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Recombinant Proteins / therapeutic use
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Ribavirin / therapeutic use*
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Treatment Outcome
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Viral Load
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Virus Activation / drug effects
Substances
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Antiviral Agents
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Biomarkers
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DNA, Viral
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Glucocorticoids
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Hepatitis B Surface Antigens
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Interferon alpha-2
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Interferon-alpha
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Oligopeptides
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RNA, Viral
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Recombinant Proteins
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Polyethylene Glycols
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Ribavirin
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entecavir
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Guanine
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telaprevir
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Prednisolone
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peginterferon alfa-2b