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Updated: Jun 25, 2026

Stabilizing Hepatocellular Phenotype Using Optimized Synthetic Surfaces
Published on: September 26, 2014
Serum transaminase elevations during pegylated interferon treatment of chronic HCV hepatitis probably induced by
B Caroleo1, L Gallelli, O Staltari
1Infective Diseases, Department of Experimental and Clinical Medicine, School of Medicine, University of Catanzaro, Germaneto, Italy.
Objective:
We report elevated serum alanine aminotransferase (ALT) levels during pegylated interferon (PEG-IFN)-alpha-2a in a patient with chronic HCV without other clinical manifestations.
Case Summary:
A 38-year-old man presented for HCV infection evaluation. Serum aspartate aminotransferase (AST) and ALT levels were 43 and 116 U/l, respectively; RT-PCR blood analysis revealed HCV-RNA infection. PEG-IFN-alpha-2b plus ribavirin treatment induced both a rapid virologic response and a normalization of transaminase plasma levels. During follow-up, an increase in transaminase and HCV-RNA values prompted us to start a new antiviral treatment with PEG-IFN-alpha-2a plus ribavirin. Four months later, after the follow-up, a new blood test documented both a HCV-RNA titer <50 U/ml and an increase in ALT and AST plasma levels. Immunostaining of the liver biopsy showed an accumulation of PEG-IFN-alpha-2a. PEG-IFN-alpha-2a elimination and the addition of recombinant IFN-alpha-2a induced normalization of the plasma transaminase levels in about 2 months.
Conclusion:
We postulate PEG-IFN-alpha-2a treatment because both the molecular weight and the distribution volume of the PEG-IFN may accumulate in the liver resulting in an increase of plasma transaminase levels. In contrast, during PEG-IFN-alpha-2b treatment, we did not document any increase in plasma transaminase values probably because of the lower molecular weight of the PEG.
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