A 40-year-old female smoker.
She had systemic lupus erythematosus, antiphospholipid syndrome tertiary hypertension, hyperparathyroidism, osteoporosis, hyperhomocysteinemia and hyperuricemia.
Hemodialysis since 1990 (renal transplant from 1991 to 1998).
Usual treatment: aluminum hydroxide, darbepoetin calcium acetate, risedronate, folic acid, polyvitamin B1/6/12, arolidopurinol, carvedilol, hydroxychloroquine, ironcen.
Since March 2008, serial "indeterminate" results (ELISA, RIBA) for HCV were observed (positive only in the NS3 fraction).
After several confirmations, despite normal transaminase levels and cross-reaction due to autoimmune underlying disease, it was decided to consider the possibility of occult HCV, which was confirmed in peripheral blood mononuclear cells (MPCμSP: 1,170 copies).
Transjugular liver biopsy showed chronic hepatitis grade/stage 0/0, and FibroScan® 6.3 KPa, APRI 0.81 and FORNS 7.59.
It does not manifest external possibility, performing PCR and viral serology to the other patients of the unit, as well as to the health personnel, without detecting new cases of classical HCV infection.
In February 2009 she received intravenous immunoglobulin IVIG (2 g/kg) due to fever prior to transplantation (finally not performed for other reasons), and azathioprine (AZT 50 mg/d) and corticosteroid therapy 2009 (CG 5 mg/d).
The PTG rose slightly and transiently in the months of March and April 2009 with a maximum of 42 IU/l.
