title: Ribavirin therapy inhibits viral replication on patients with chronic hepatitis e virus infection.
abstract: OBJECTIVE
  Hepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients. Pegylated α-interferon can effectively treat chronic HEV infection after liver transplantation but is contraindicated for kidney transplantation. We assessed the antiviral effect of ribavirin monotherapy in patients with chronic HEV infection following kidney transplantation.
  
  
  METHODS
  In a pilot study performed at Toulouse University Hospital, 6 patients that received kidney transplants who were positive for HEV RNA (infected with HEV for 36.5 months; [range, 11-46 months]) were given ribavirin monotherapy for 3 months. Ribavirin was given at 600-800 mg/day in 2 separate doses, based on the patient's ability to clear creatinine.
  
  
  RESULTS
  Median serum concentration of HEV RNA at baseline was 5.77 log copies/mL (range, 4.35-7.35 log copies/mL). Three months after ribavirin therapy commenced, HEV RNA was undetectable in serum samples from all patients. A sustained virologic response was observed in 4 patients; the other 2 patients relapsed at 1 and 2 months after ribavirin therapy ended. At the end of the study, all patients had normal levels of alanine and aspartate aminotransferase. Anemia was the main side effect caused by ribavirin therapy.
  
  
  CONCLUSIONS
  Ribavirin monotherapy inhibits the replication of HEV in vivo and might induce a sustained virological response in patients with chronic HEV infections. Further studies are required to determine the optimal duration of ribavirin therapy.
authors: Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
authors: Nassim
authors: N
authors: Kamar
authors: Lionel
authors: L
authors: Rostaing
authors: Florence
authors: F
authors: Abravanel
authors: Cyril
authors: C
authors: Garrouste
authors: Sebastien
authors: S
authors: Lhomme
authors: Laure
authors: L
authors: Esposito
authors: Grégoire
authors: G
authors: Basse
authors: Olivier
authors: O
authors: Cointault
authors: David
authors: D
authors: Ribes
authors: Marie Béatrice
authors: MB
authors: Nogier
authors: Laurent
authors: L
authors: Alric
authors: Jean Marie
authors: JM
authors: Peron
authors: Jacques
authors: J
authors: Izopet
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000032:analysis; D016751:Hepatitis E / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D016752:Hepatitis E virus / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014779:Virus Replication / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D012254:Ribavirin