Three-month pegylated interferon-alpha-2a therapy for chronic hepatitis E virus infection in a haemodialysis patient.
Hepatitis E virus (HEV) can induce chronic hepatitis in immunosuppressed patients. There is no established treatment for HEV infection. Pegylated interferon-alpha-2a (Peg-IFN-alpha-2a) has been successfully used for treating HEV infection in liver transplant patients with chronic hepatitis. A kidney transplant patient with chronic HEV infection evolved to end-stage kidney disease and started haemodialysis. Three months after immunosuppressive therapy was stopped, HEV RNA was still detected both in serum and in stools. Before considering a retransplantation, we decided to initiate Peg-IFN-alpha-2a therapy to eradicate the virus. A 3-month course of Peg-IFN-alpha-2a was scheduled, and the latter was started at the weekly dose of 135 microg. Serum HEV RNA became negative by Week 3 of Peg-IFN-alpha-2a therapy, and remained negative until the last follow-up, i.e. 6 months after anti-viral therapy was stopped. Hence, we report the first known case of a 3-month course of Peg-IFN-alpha-2a inducing a sustained virological response in this HEV-positive and RNA-positive haemodialysis patient who had failed to be cleared of the virus after immunosuppressant withdrawal.
Kamar
Nassim
N
Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032, Toulouse Cedex 9, France. kamar.n@chu-toulouse.fr
Abravanel
Florence
F
Garrouste
Cyril
C
Cardeau-Desangles
Isabelle
I
Mansuy
Jean Michel
JM
Weclawiak
Hugo
H
Izopet
Jacques
J
Rostaing
Lionel
L
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D016751:Hepatitis E / Q000188:drug therapy*; D016752:Hepatitis E virus; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D009394:Nephritis, Hereditary / Q000601:surgery; D009894:Opportunistic Infections / Q000188:drug therapy / Q000821:virology; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins; D006435:Renal Dialysis; D016896:Treatment Outcome
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a