Benefit of Pegylated Interferon-α-2a/Ribavirin in a Patient with Common Variable Immunodeficiency and Hepatitis C Virus Cirrhosis after Liver Transplantation and Splenic Embolization

Partial splenic embolization and peg‐IFN plus RBV in liver transplanted patients with hepatitis C recurrence: safety, efficacy and long‐term outcome

“…On the other hand, although the usefulness of early stopping rules at week 4 and 12 has demonstrated in LT‐subjects (4, 28), it should be noted that one subject reaching SVR had a late HCV RNA clearance, suggesting that the decision of therapy discontinuation in this rare situation should be individualized. Although in our patients the most significant benefit should be related to antiviral therapy, PSE per se has shown to improve liver function (10, 11, 13), and contributed to the long‐term benefit observed in this series, with an overall survival rate of 75% despite the low rate of SVR.…”

“…In all cases PSE and follow‐up have been performed according a scheduled protocol as previosuly described (10, 11, 13), including clinical, analytical and radiological assessment; PSE was performed by the same team of interventional vascular radiologists after pneumococcal vaccination, and under intravenous antibiotic, sedative and antiemetic therapy. A femoral artery approach was used for superselective distal catheterization of the splenic artery (Seldinger technique), with injection of polyvinyl‐alcohol particles (355–500 μm) suspended in a solution of penicillin, gentamicin, and non‐ionic iodine contrast, to obtain an splenic infarction rate between 50 and 80%.…”

“…Partial splenic embolization (PSE) is an effective alternative to surgical splenectomy for the treatment of cytopenias in cirrhotic patients with hypersplenism, specially thrombocytopenia (9). Our group and others have previously reported preliminary experiences with PSE among LT patients aimed to allow full‐dose peg‐IFN plus RBV (10–12). Moreover, in HCV‐LT patients with chronic graft dysfunction and cholestasis PSE led to an improvement in the graft function due to the reversal of an undiagnosed splenic artery steal syndrome related to chronic hypersplenism masked by HCV recurrence (13).…”

Use of Cytokine Therapy in Primary Immunodeficiency

“…Pegylated IFN-α-2a/ RBV was given to a 21-year-old man with common variable immunodeficiency (CVID) who contracted HCV from IVIG. Treatment was associated with clearance of HCV RNA and was well tolerated [35].…”

A review on guidelines for management and treatment of common variable immunodeficiency

“…In CVID patients with pulmonary diseases, new therapeutic approaches focus on IL-2 therapy [117][118][119][120], short and long-acting inhaled B 2 -agonists in bronchiectasis [121,122] and leukotriene receptor antagonists [113]. Although most bronchiectatic CVID patients tend to have generalized lung damage, selected cases with highly localized disease may benefit from surgical procedure [123].…”