Brief Communication: Case Reports of Ribavirin Treatment for Chronic Hepatitis E

Abstract

None.

Chronic Hepatitis E Virus Infection and Treatment

“…3,24,30,41,83,84 The clinical and laboratory features of chronic HEV in these patients are similar to those in recipients of a SOT. A few cases have been treated successfully with pegylated interferon or ribavirin as monotherapies.…”

“…11,12,14,18,[36][37][38][39][40][41][42][43][44][45][46][47][48] A large multicenter retrospective study, which included 85 adult patients with a SOT (kidney-, liver-, kidney-pancreas-, islet-, heart-, and lung-transplants) showed that 34.1% had spontaneous clearance of HEV within the first 6 months after HEV was diagnosed and no HEV reactivation later on, whereas 65.9% developed chronic hepatitis. 49 Interestingly, in contrast to non-immunosuppressed patients who usually present to hospital with jaundice, 50 when HEV was diagnosed, only 32% of patients were symptomatic.…”

“…54,55 In vitro, it has been shown that HEV downregulates IFN-a-induced gene expression. 56 Several small series have also evaluated ribavirin as a monotherapy to treat chronic HEV infection in adult patients with a SOT 12,17,41,43,45,46,57,58 ; 3-6-month courses of ribavirin therapy were given. A sustained virological response was observed in the majority of patients.…”

“…A few cases have been treated successfully with pegylated interferon or ribavirin as monotherapies. 41,84,85 …”

Chronic hepatitis E: A brief review

“…While all three patients had undetectable HEV RNA in serum and stool at 12 wk of treatment, one patient developed acute humoral graft rejection while HEV RNA was redetected in another patient, 2 wk after completion of interferon therapy. Due to the risk of graft rejection from decreasing dose of immunosuppressive drugs and using pegylated interferon α, Mallet et al [59] studied the use of ribavirin in treating two patients with chronic hepatitis E (one was post kidney and pancreas transplant and other has idiopathic CD4 T lymphocytopenia). Both patients received ribavirin at a dose of 12 mg/kg per day for 12 wk.…”