2 years transplant rejection

My husband has hepc and had a liver transplant 2 years ago. He was on interferon and ribavarin for 18 months and his viral load never went under 1 million. They took him off and after 1 month his liver enzymes went way up alt 400s and ast 300s, GGT is 568. He had a biopsy and they said it is partial rejection and also the hepc is attacking the new liver. Is it unusual for rejection to happen after 2 years? do you think it is because of the hep c. And when they get the rejection under control what can they do for the hepc. The doctors say they worry about autoimmune hepatitis if they put him back on the shots. We don't know where to turn. I would appreciate your thoughts and if you know of any other medication that is coming out for hepc.  Thanks so much, Ruth

[Thomas D Schiano, MD]

the interferon treatment can in fact trigger rejection.  it can also trigger autoimmune hepatitis.  sometimes rrequent biopsies are necessary to sort this out. depending on how advanced the HCV is is what the interferon treatment should be predicated upon.  unfortunately I do not think we are close to having any new HCV medications in the post-liver transplant setting.