Brief communication: case reports of ribavirin treatment for chronic hepatitis E.
BACKGROUND
There is currently no accepted treatment of chronic hepatitis E virus (HEV) infection.


OBJECTIVE
To report 2 patients in whom ribavirin therapy seemed to alter the natural history of chronic HEV infection.


METHODS
Case reports.


METHODS
Hepatology unit of a tertiary care center in France.


METHODS
A kidney and pancreas transplant recipient and a patient with idiopathic CD4(+) T lymphocytopenia, both with biopsy-proven chronic HEV infection.


METHODS
Patients received oral ribavirin, 12 mg/kg of body weight daily for 12 weeks.


METHODS
Liver function tests, detection of HEV RNA (viremia and stool shedding) by reverse transcriptase polymerase chain reaction, and anti-HEV IgM and IgG antibodies.


RESULTS
Both patients had normalized liver function test results after 2 weeks of treatment and cleared HEV after 4 weeks of treatment. Hepatitis E virus RNA remained undetectable in the serum and stools throughout follow-up (3 months and 2 months for the first and second patient, respectively). Side effects were considered mild.


CONCLUSIONS
Given the relatively short follow-up, the achievement of HEV eradication could not be claimed.


CONCLUSIONS
Ribavirin is a potentially effective treatment of HEV infection and should be evaluated in patients with chronic HEV infection.


BACKGROUND
None.
Mallet
Vincent
V
Institut Cochin, Université Paris Descartes (Unité Mixte de Recherche S1016), Paris, France. vincent.mallet@cch.aphp.fr
Nicand
Elisabeth
E
Sultanik
Philippe
P
Chakvetadze
Catherine
C
Tessé
Sophie
S
Thervet
Eric
E
Mouthon
Luc
L
Sogni
Philippe
P
Pol
Stanislas
S
D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D016751:Hepatitis E / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000276:immunology; D012254:Ribavirin / Q000008:administration & dosage*; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000276:immunology
D000998:Antiviral Agents; D012254:Ribavirin