The burden of hepatitis E among patients with haematological malignancies: A retrospective European cohort study

Mortality and morbidity of locally acquired hepatitis E in the national Scottish cohort: a multicentre retrospective study

“…Haematological malignancy was a strong independent predictor of mortality ( P = 0.005). This supports the work of von Felden et al whose recent multicentre European study found a mortality of 16% among viraemic HEV patients with haematological malignancy 37 . In the current study, ribavirin SVR rate in the 25 chronic HEV was 76% with four patients having a relapse and two patients dying during their first course of ribavirin.…”

Burden of hepatitis E infection and associated healthcare resource utilization among hematological malignancy-related hospitalizations: A national perspective in the United States, 2007–2014

“…1 The higher survival rate reported in our study compared to the study by von Felden et al could be due to variations in the patient demographics, risk factors for liver failure, and cancer staging at the time of diagnosis of HEV. 1 Due to privacy restrictions set forth by Healthcare Cost and Utilization Project (HCUP) regarding smaller sample sizes (<11), we could not report the prevalence of liver failure or other acute events in both the groups; however, we observed that HEV infection among patients with hematological malignancy was associated with prolonged length of hospitalization and higher hospital charges in comparison to the patients without hematological malignancy. Therefore, we believe that the US inpatient data reported in this study indicate a relatively high burden of HEV among patients with hematologic malignancies as reported by von Felden et al from European centers.…”

“…Dr. Desai and colleagues report a high burden of hepatitis E in their cohort based on longer hospital stay and higher costs compared to hematological patients without hepatitis E. 1 Our study did not assess these socio-economic parameters, but given the severity of the disease in terms of liver-related complications among our patients, we believe that an economic burden of hepatitis E in our cohort likely coexists. As outlined by the authors themselves, Dr. Desai and colleagues were not able to delineate the clinical burden of hepatitis E, including chronic hepatitis E, extrahepatic manifestations and liver failure, which clearly represents a missing piece required to further understand potential disparities in the course of hepatitis E between both continents.…”

“…2 These differences might account for the lower survival rates in our cohort compared to patients with hepatitis E and hematological malignancy reported by Dr. Desai and colleagues (84% vs. 91.8%). 1,2 In conclusion, the letter by Dr. Desai and colleagues represents the first large scale data on HEV in hematological patients in the U.S., and underscores the burden of this disease among this special patient population despite a potentially less aggressive HEV genotype and lower prevalence in the general U.S. population compared to European populations. Nevertheless, data on liver morbidity and liver-related mortality in patients with hematological malignancy and other immunocompromised cohorts in the U.S. are urgently needed to better understand potential disparities in the clinical course of the disease…”

“…We read the paper recently published by von Felden et al with great interest. 1 The authors have commendably presented multicenter data concerning the burden and impact of HEV infection among patients with hematological malignancies. The findings are important in that the occurrence of HEV infection can alter the course of hematological malignancy, even in patients with stable disease.…”