title: Sustained virologic response with ribavirin in chronic hepatitis E virus infection in heart transplantation.
abstract: Hepatitis E virus (HEV) is an emerging problem amongst transplant recipients. We report a patient with chronic HEV hepatitis after a heart transplant. The patient received a 3-month course of oral ribavirin (17 mg/kg/day). HEV RNA became undetectable in the serum after 1 month of treatment and remained undetectable in serum and stool samples until the last follow-up, 2 months after completion of ribavirin therapy. The values of liver function indicators returned to normal reference ranges. The main ribavirin-induced side effect was a significant but well-tolerated anemia. We confirmed that ribavirin may induce a sustained virologic response (4 months after ribavirin cessation) in heart transplant patients with chronic HEV infection. Liver cytolysis is rather common in patients after heart transplantation. Rapid evolution to liver fibrosis lesions and available anti-viral therapy highlight the need to look for HEV infection in heart transplant recipients with unexplained hepatitis.
authors.affiliation: Service de Bactériologie-Virologie, CHRU Bretonneau, Tours, France; INSERM U966 Université François-Rabelais de Tours, UFR Médecine, Tours, France. antoine.chaillon@univ-tours.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Chaillon
authors.forename: Agnès
authors.initials: A
authors.lastname: Sirinelli
authors.forename: Anne
authors.initials: A
authors.lastname: De Muret
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nicand
authors.forename: Louis
authors.initials: L
authors.lastname: d'Alteroche
authors.forename: Alain
authors.initials: A
authors.lastname: Goudeau
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D002908:Chronic Disease; D005500:Follow-Up Studies; D016027:Heart Transplantation; D016751:Hepatitis E / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase