Factors Associated With Chronic Hepatitis in Patients With Hepatitis E Virus Infection Who Have Received Solid Organ Transplants

A Mutation in the Hepatitis E Virus RNA Polymerase Promotes Its Replication and Associates With Ribavirin Treatment Failure in Organ Transplant Recipients

“…transplant or HIV patients, 4,5 and may lead to cirrhosis, graft loss and death. 6 Ribavirin (RBV) monotherapy is the treatment-of-choice for most patients. 7,8 However, treatment failure has been observed, either as a partial response to ribavirin or viral recurrence after therapy cessation, and is possibly linked to dose reductions because of severe anemia in some cases.…”

Chronic Hepatitis E Virus Infection and Treatment

“…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. 49 Fatigue was the main reported symptom, and only one patient was icteric.…”

“…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. 49 Fatigue was the main reported symptom, and only one patient was icteric. Liver-enzyme levels were increased ($300 IU/L), but were much lower than those usually observed in immunocompetent patients ($3000-5000 IU/L).…”

Hepatitis E virus infection in Iranian kidney-transplant patients

“…After kidney transplantation, HEV-related liver fibrosis can lead rapidly to cirrhosis [5]. The use of tacrolimus, rather than cyclosporine A, and a low platelet count at HEV diagnosis have been identified as predictive factors for chronic HEV infection [6]. However, decreased immunosuppressant dose can result in HEV clearance in nearly one-third of patients [6].…”

“…The use of tacrolimus, rather than cyclosporine A, and a low platelet count at HEV diagnosis have been identified as predictive factors for chronic HEV infection [6]. However, decreased immunosuppressant dose can result in HEV clearance in nearly one-third of patients [6]. In addition, ribavirin monotherapy can be efficacious in treating chronic HEV infection [7].…”