An Unexpected Cause of Recurrent Jaundice after Resolution of Acute Hepatitis E

Verbeeck, Annabelle; Becker, Ann De; Reynaert, Hendrik

doi:10.1159/000508425

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…Most of the available data on HEV infections in patients with hematological disorders are based on single case reports and small case series (7,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Even in the current version of the ECIL (European Conference on Infection in Leukemia) and the EASL (European Association for Study of the Liver) guidelines (35,36), questions if HEV infection requires changes of systemic cancer therapy in patients with hematological disorders such as: how often are hepatitis E-related therapy modifications in patients with hematological disorders, what kind of therapy modifications do occur and what is their impact on the overall treatment schedule remain unanswered.…”

Section: Introductionmentioning

confidence: 99%

Clinical features of hepatitis E infections in patients with hematologic disorders

et al. 2022

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Hepatitis E virus is increasingly being reported to cause chronic infection in immunocompromised patients. However, less is known about patients with underlying hematologic disease. In particular, the impact of hepatitis E infection on oncologic therapy has been poorly described. In this retrospective single-center analysis, we analyzed 35 hematological patients with hepatitis E, including 20 patients under active oncologic treatment and 15 patients who were in the post-treatment follow-up or under active surveillance. The primary aim was to describe the clinical courses with particular focus on any hepatitis E-related therapy modifications of cancer-directed therapy. In the majority (60%) of patients who were under active oncological treatment, hepatitis Erelated therapy modifications were made with 25% of deaths due to progression of hematological disease. In patients with concomitant oncological treatment, no hepatitis Erelated death occurred. In contrast, two patients in the follow-up group died from hepatitis Eassociated acute-on-chronic liver failure. Chronic hepatitis E was observed in 34% of all cases and 43% received ribavirin therapy, of those 27% achieved sustained virologic response. CD20-directed therapy was the only independent risk factor for developing chronic hepatitis E. We conclude that CD20-directed treatment at any time point is a risk factor for developing chronic hepatitis E. Nevertheless, since mortality from the progression of hematological disease was higher than hepatitis E-related mortality, we suggest a careful case-by-case decision of cancer-treatment modification. Patients in post-treatment follow-up phase may also suffer from severe courses and hepatitis E chronification occurs as frequently as in patients undergoing active therapy.

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