treatment of autoimmune haemolytic anaemia with hepatitis c virus-a real challenge

Hepatitis C virus (HCV) infection is a potentially curable disease. The first line of treatment is pegylated interferon and ribavirin, both of which cause haemolysis. HCV itself causes autoimmune haemolytic anaemia (AIHA). Treatment of AIHA with steroid is contraindicated in patients on interferon. We report the successful treatment of a patient with AIHA infected with HCV whose treatment was a real challenge due to the risk of exacerbation of haemolysis by antiviral treatment. We describe the successful treatment of this patient initially with corticosteroids followed by pegylated interferon and gradual increase of the dose of ribavirin