Effects of corticosteroids on HCV infection

Hepatitis C Virus (HCV) Reactivation Caused by Steroid Therapy for Dermatomyositis

“…Among these agents, rituximab is reported to be a high-risk drug related to HCV reactivation (13). Several pathogenic mechanisms involving the association between steroids and HCV reactivation have been postulated, including enhanced HCV infectivity due to an upregulated expression of viral receptors on the surface of hepatic cells (17) and enhanced viral replication both in vitro and in vivo (4). HCV genotype 2, in particular, may be a risk factor for reactivation (18).…”

“…In contrast to that observed for HBV, the frequency of HCV reactivation is low. HCV reactivation may occur as a consequence of the loss of host immune control over the virus (4,5); however, little is known about the overall frequency and mechanisms of HCV reactivation (6). HCV reactivation is commonly defined as a threefold or greater increase in the serum alanine aminotransferase (ALT) level in patients without tumor infiltration to the liver who have not received hepatotoxic drugs and have no recent history of blood transfusions or other systemic infections in addition to HCV.…”

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

“…42 Furthermore, available data on recurrence in the graft after liver transplantation suggest that corticosteroids should be tapered slowly to limit the risk of early recurrent HCV hepatitis and the risk of cholestatic fibrosing hepatitis. 43,44 Thiopurines ⁄ methotrexate. In vitro, azathioprine has anti-viral activity against HCV.…”

Sarcoidosis Associated With Pegylated Interferon Alfa and Ribavirin Treatment for Chronic Hepatitis C

“…Steroids, which are the main treatment for systemic sarcoidosis, increase the hepatitis C viral load both in vitro and in vivo. 20 Physicians should thus exert caution in treating interferon alfa-associated sarcoidosis with systemic corticosteroids.…”