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Ribavirin treatment of acute and chronic hepatitis E: a single‐centre experience
Author(s) -
Pischke Sven,
Hardtke Svenja,
Bode Ulrike,
Birkner Stephan,
Chatzikyrkou Christos,
Kauffmann Wolfgang,
Bara Christoph L.,
Gottlieb Jens,
Wenzel Juergen,
Manns Michael P.,
Wedemeyer Heiner
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12114
Subject(s) - ribavirin , medicine , immunosuppression , hepatitis e virus , clearance , hepatitis c , chronic hepatitis , immunology , virology , virus , genotype , biochemistry , urology , gene , chemistry
Background The role of ribavirin for treatment of severe acute or chronic hepatitis E virus ( HEV ) infection is not well defined. Aims To investigate the applicability and efficacy of ribavirin therapy in acute and chronic HEV infections within a large single‐centre cohort. Materials & Methods Clinical courses of forty‐four German HEV ‐infected individuals were analysed. Results In a prospective case series, we observed spontaneous recovery from acute symptomatic HEV ‐infection in 10/11 immunocompetent individuals. Ribavirin therapy was initiated in one patient with severe acute HEV ‐genotype‐1e infection who rapidly improved liver function and cleared HEV . Of 15 organ transplant recipients with prolonged HEV viraemia, reduction in immunosuppression led to HEV ‐clearance in three patients, while ribavirin therapy was initiated in 11 subjects. A rapid response with undetectable HEV ‐ RNA occurred in nine subjects. One patient died after experiencing a virological breakthrough associated with ribavirin dose reduction because of severe anaemia. Discussion Ribavirin is a safe treatment option for HEV infections. However, the optimal dose of ribavirin for the treatment of chronic hepatitis E remains to be determined as treatment failure may occur.