title: Treatment of severe acute hepatitis E by ribavirin.
abstract: BACKGROUND
  Acute hepatitis E is associated with a higher rate of mortality as compared to hepatitis A or B infections in some series. To date no treatment has been recommended for acute hepatitis E. However, ribavirin has been recently reported to be highly effective to treat solid-organ-transplant recipients chronically infected with hepatitis E virus (HEV).
  
  
  OBJECTIVE
  We report here on the use of ribavirin to treat severe acute HEV infection in a non-immunocompromized patient. This 61-year-old-man presented with acute hepatitis with HEV genotype 3. Seven days after admission, prothrombin index was 38%, bilirubinaemia was 550 μmol/L and alanine aminotransferases level was still increasing, reaching 4565IU/L. No hepatic encephalopathy was noted. Ribavirin (1200 mg/day) was introduced.
  
  
  RESULTS
  Liver biological tests showed rapid improvement concurrently with a decrease in HEV RNA levels in serum samples. Therapy was interrupted after 21 days. At that time, ALT had normalized, bilirubinemia was 138 μmol/L, and HEV RNA was almost undetectable in the serum.
  
  
  CONCLUSIONS
  Ribavirin therapy could be an effective treatment of severe acute hepatitis E.
authors.affiliation: Service d'Hépato-Gastroentérologie, Centre Hospitalo-Universitaire Conception, 147 boulevard Baille, 13385 Marseille Cedex 05, France. rene.gerolami@ap-hm.fr
authors.forename: René
authors.initials: R
authors.lastname: Gerolami
authors.forename: Patrick
authors.initials: P
authors.lastname: Borentain
authors.forename: Ferdaous
authors.initials: F
authors.lastname: Raissouni
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.forename: Caroline
authors.initials: C
authors.lastname: Solas
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D000208:Acute Disease; D000998:Antiviral Agents / Q000627:therapeutic use*; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D012254:Ribavirin