Treatment of Hepatitis E

Hui, Wei; Wei, Luqing

doi:10.1007/978-981-99-1304-6_15

Cited by 3 publications

(4 citation statements)

References 87 publications

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“…Though no definitive approved options are available, Ribavirin is effective and widely used in the treatment of cases of HEV-associated fulminant hepatitis or chronic liver failure and other HEV complications[ 10 , 32 , 35 , 36 ]. Ribavirin clears the HEV virus by depleting guanosine triphosphate pools, thus inhibiting HEV-RNA replication[ 37 ].…”

Section: The Challengesmentioning

confidence: 99%

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Hepatitis E virus infections

Nagoba,

Rayate

2024

World J Virol

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Hepatitis E virus (HEV) infection is now endemic worldwide. Most patients with acute infection recover uneventfully. Outbreaks and sporadic cases, particularly in high-risk individuals are emerging increasingly. The patients with risk factors like pregnancy and pre-existing chronic liver disease, present with or progress rapidly to severe disease. Immuno-suppression in post-transplant patients is an additional risk factor. Standardized FDA-approved diagnostic tests are the need of the hour. Further studies are needed to establish guideline-based treatment regimen and outbreak preparedness for HEV to decrease global morbidity, mortality, and healthcare burden. Policies for screening donors and transplant cases are required.

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Section: The Challengesmentioning

confidence: 99%

“…This step alone can lead to HEV clearance of patients[ 5 , 10 , 38 ]. In addition to dose reduction, treatment may include Ribavirin and Pegylated interferon-alpha[ 7 , 36 , 39 ]. Ribavirin is the safe and preferred agent to be consumed for three months or as per the response.…”

Section: The Challengesmentioning

confidence: 99%

Hepatitis E virus infections

Nagoba,

Rayate

2024

World J Virol

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“…Thus, HEV-ALF is considered an issue that has long been underestimated. Moreover, the mechanism underlying HEV-ALF progression has not been fully elucidated, and effective treatments have rarely been reported [ 1 , 12 , 13 ]. Current treatment strategies for HEV-ALF usually involve critical care, artificial liver support, and liver transplantation, which often cause high medical expenditures and are usually unavailable in resource-limited areas [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the mechanism underlying HEV-ALF progression has not been fully elucidated, and effective treatments have rarely been reported [ 1 , 12 , 13 ]. Current treatment strategies for HEV-ALF usually involve critical care, artificial liver support, and liver transplantation, which often cause high medical expenditures and are usually unavailable in resource-limited areas [ 13 ]. Studies have reported varying estimates of its incidence and mortality, presumably because the specific geographical regions, HEV GTs, and populations focused on in these studies were not identical.…”

Section: Introductionmentioning

confidence: 99%

The burden of HEV-related acute liver failure in Bangladesh, China and India: a systematic review and meta-analysis

Dong,

Chang,

Luo

et al. 2023

BMC Public Health

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Background Hepatitis E can potentially progress to HEV-related acute liver failure (HEV-ALF). East and South Asia bear a substantial burden of HEV infection, with Bangladesh, China, and India facing the most severe threat in this region. Therefore, we conducted a systematic review and meta-analysis to evaluate the burden of HEV-ALF in these three high-risk countries. Methods A systematic literature search was performed utilizing PubMed, the Cochrane Library, Medline, Embase, and Web of Science databases. Studies in English or Chinese that reported data on the burden of HEV-ALF in Bangladesh, China and India were included. Outcomes were pooled with meta-analysis utilizing R software. Estimates were calculated with random-effects models, and subgroup analysis and sensitivity analysis were conducted to address heterogeneity. Egger’s test and Begg’s test were performed to assess publication bias. Results A total of 20 eligible studies were included in this study. The pooled HEV-attributable proportion of viral-related acute liver failure was estimated to be 40.0% (95% CI: 0.28–0.52), 30.0% (95% CI: 0.18–0.44), and 61.0% (95% CI: 0.49–0.72) among non-pregnant individuals in India, China and Bangladesh, while in Indian pregnant females, it was 71.0% (95% CI: 0.62–0.79). The combined prevalence among non-pregnant HEV-infected participants was 28.0% (95% CI: 0.20–0.37) and 10.0% (95% CI: 0.01–0.28) in India and China, and it was 34.0% (95% CI: 0.27–0.42) in Indian pregnant females with HEV infection. The overall mortality of HEV-ALF was estimated to be 32.0% (95% CI: 0.23–0.42) and 64.0% (95% CI: 0.50–0.77) among the non-pregnant and the pregnant participants in India, and it was 23.0% (95% CI: 0.14–0.34) in Chinese non-pregnant participants. Conclusions The burden of HEV-ALF in Bangladesh, China, and India is non-negligible despite geographic and population heterogeneity. The prevention of HEV infection and early recognition of HEV-ALF are of great significance, especially in high-risk countries and populations. Registration PROSPERO registration ID is CRD42022382101.

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Associations of Lipid Profiles With the Onset of HEV‐Related Acute Liver Failure: A Multicenter Cohort Study

Dong,

Xue,

Chen

et al. 2024

Journal of Medical Virology

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Hepatitis E virus (HEV) is one of the major etiologies for acute liver failure. This multicenter retrospective cohort study aimed to investigate the associations of lipid profiles with the risk of HEV‐related acute liver failure (HEV‐ALF) among hospitalized patients with acute hepatitis E. A total of 1061 participants were obtained from three tertiary medical centers in Jiangsu, China, between February 2018 and May 2024. Univariate and multivariate Cox regression models were constructed to assess the associations between lipid profiles and the risk of HEV‐ALF onset. The time‐dependent area under the receiver‐operating‐characteristic curve (AUROC) and decision curve analysis were used to further evaluate the predictive value of blood lipids. After adjusting for potential confounders, total cholesterol (HR = 0.535, 95% CI: 0.437–0.656, p < 0.001), high‐density lipoprotein‐cholesterol (HR = 0.065, 95% CI: 0.027–0.154, p < 0.001), low‐density lipoprotein‐cholesterol (HR = 0.653, 95% CI: 0.512–0.833, p = 0.001), and apolipoprotein A (ApoA) (HR = 0.006, 95% CI: 0.002–0.020, p < 0.001) were significantly associated with a reduced risk of HEV‐ALF. Moreover, blood ApoA exhibited excellent discrimination ability and net benefit for predicting 7‐day (AUROC = 82.47%, 95% CI: 77.92–87.02) and 14‐day (AUROC = 78.81%, 95% CI: 74.13–83.49) HEV‐ALF onset. The findings may provide further evidence on the progression of HEV infection and future risk prediction.

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Treatment of Hepatitis E

Cited by 3 publications

References 87 publications

Hepatitis E virus infections

Hepatitis E virus infections

The burden of HEV-related acute liver failure in Bangladesh, China and India: a systematic review and meta-analysis

Associations of Lipid Profiles With the Onset of HEV‐Related Acute Liver Failure: A Multicenter Cohort Study

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