A case of hepatitis C virus-associated liver cirrhosis with cryoglobulinemia, esophageal varices and ascites treated with pegylated interferon-α 2b and ribavirin

A 43-year-old Japanese man with hepatitis C virus-liver cirrhosis was referred to our hospital because of massive ascites. He had been treated with insulin injection for diabetes mellitus since 29-year-old. His data on admission showed total bilirubin of 0.3 mg/dl, AST 25 IU/l, ALT 23 IU/l, serum albumin 2.1 g/dl and creatinin 2.4 mg/dl, which were compatible with hypoalbuminemia and chronic renal failure. HCVRNA showed genotype 2A and a load of 5.1 logIU/ml. Liver cirrhosis with cryoglobulinemia was diagnosed. After endoscopic variceal ligation and paracentesis, peginterferon-α 2b/ribavirin therapy was initiated. Four weeks after, HCVRNA and serum cryoglobulinemia disappeared, while protein of 5.1 g/day in urine decreased to 2.6 g/day. At the end of 24-week therapy, HCVRNA and serum cryoglobulinemia were confirmed to be negative. PEGIFN/RBV therapy was effective for hepatitis C virus-associated liver cirrhosis with cryoglobulinemia.