Chronic Hepatitis E Virus Infection and Treatment

Kamar, Nassim; Izopet, Jacques; Dalton, Harry R.

doi:10.1016/j.jceh.2013.05.003

Cited by 66 publications

(73 citation statements)

References 110 publications

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“…44 Further, ribavirin is also shown to inhibit the viral RNA replication and induce a sustained virological response in chronically infected patients. 45,46 One preliminary report from India suggests that ribavirin may be an effective and safe drug for treatment of HEV-ACLF. 47 The investigators Goyal et al treated four patients of HEV-ACLF by ribavirin in the dose of 200-600 mg/d for a median duration of 12 (range 3-24) weeks.…”

Section: Treatment Of Hev-related Aclfmentioning

confidence: 99%

Hepatitis E and Acute-on-Chronic Liver Failure

Kumar

Saraswat

2013

Journal of Clinical and Experimental Hepatology

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Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis (AVH) globally. It causes large scale epidemics of AVH across the low-and middle income countries in Asia and Africa, and also causes sporadic cases of AVH in the same geographical region. AVH due to HEV is usually an acute, self-limiting illness, similar in clinical presentation to AVH caused by hepatitis A virus (HAV). When HEV causes AVH in patients of chronic liver disease it may worsen rapidly to a syndrome called acute-on-chronic liver failure (ACLF) leading to very high mortality. Acute deterioration of liver function in a patient with compensated chronic liver disease is the characteristic feature of ACLF. The typical disease course of patients with ACLF is the appearance of organ failure, which progresses to multi-organ failure and death. Many publications have reported HEV as one of the leading causes for ACLF from Asia and Africa, where HEV is endemic. The mortality rate of HEV-related ACLF (HEV-ACLF) ranges from 0% to 67% with a median being 34%. These patients require admission in the intensive care unit and they benefit from a team approach of clinicians with expertise in both hepatology and critical care. The goals of treatment are to prevent further deterioration in liver function, reverse precipitating factors, and support failing organs. Liver transplantation is required in selected patients to improve survival and quality of life. One preliminary report suggests that ribavirin may be an effective and safe drug for treatment of HEV-ACLF however this requires validation in large trials. ( J CLIN EXP HEPATOL 2013;3:225-230)

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Section: Treatment Of Hev-related Aclfmentioning

confidence: 99%

Hepatitis E and Acute-on-Chronic Liver Failure

Kumar

Saraswat

2013

Journal of Clinical and Experimental Hepatology

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“…J Clin Exp Hepatol 2013;3:134-140) and hence is not discussed further here. 87 Another unusual feature of HEV infection in these areas is the occurrence of a wide variety of neurological syndromes in association with genotype 3 HEV infection. 88,89 However, these syndromes are not seen in patients with acute infection due to genotype 1 or 2 HEV infection in high-endemicity areas.…”

Section: Clinical Outcomes In Low-endemicity Regionsmentioning

confidence: 99%

Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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“…HEV was considered to cause only self-limiting acute hepatitis, but there are a number of case reports of chronic infection in immunocompromised individuals (143,258,312). Surprisingly, the virus has been reported to cause extrahepatic illness, including neurological complications (such as Guillain-Barré syndrome, neuritis), glomerulonephritis and pancreatitis (13,313).…”

Section: Discussionmentioning

confidence: 99%

“…The viremic phase begins 2-3 weeks after infection, and can last for 10 weeks (12,255). Chronic HEV infection with genotypes 3 have been documented in solid organ transplant and blood transfusion recipients (143,256,257), and in such cases, viral RNA can persist for more than 3 months (258). HEV IgM appears after 3-4 weeks and is detectable for 6 months, while HEV IgG is detectable 4-5 weeks post infection (12) and can be present for more than 12 years (12).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, HEV has been transmitted to a recipient from infected plasma after treatment with the Intercept system (synthetic psoralen amotosalen HCL treatment and ultraviolet light A) (18). Given that HEV infection in immunocompromised individuals, such as many transfusion recipients, can lead to chronic infection (258), it is essential to assess HEV risk to blood supply safety.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the risks posed by hepatitis E virus to blood supply safety

Shrestha¹

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Transfusion is an important field of clinical medicine, responsible for saving the lives of millions of people. However, concerns remain for patients' safety from adverse reactions and transfusion transmissible infections (TTIs). While risks from well-known TTIs (such as human immunodeficiency virus, human T-lymphotrophic virus, hepatitis B virus, hepatitis C virus and Treponema pallidum) have been reduced in developed nations, developing countries struggle to maintain the minimum screening requirements for these infections.

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Chronic Hepatitis E Virus Infection and Treatment

Cited by 66 publications

References 110 publications

Hepatitis E and Acute-on-Chronic Liver Failure

Hepatitis E and Acute-on-Chronic Liver Failure

Hepatitis E: Epidemiology and Natural History

Evaluating the risks posed by hepatitis E virus to blood supply safety

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