title: Treatment of chronic hepatitis E in a patient with HIV infection.
abstract: BACKGROUND
  Hepatitis E virus (HEV) infections in immunosuppressed patients can result in chronic hepatitis that rapidly progresses to cirrhosis (1, 2). When immunosuppressed transplant recipients are treated with pegylated -interferon and ribavirin, HEV clears and liver histology improves (2). However, we are not aware of reports about how this therapy works in patients with HIV infection.
  
  
  OBJECTIVE
  To describe the clinical and laboratory response to antiviral therapy for chronic HEV infection in a patient also infected with HIV.
  
  
  METHODS
  We studied a 48-year-old bisexual male with HIV- 1 infection who was chronically infected with HEV genotype 3a and had several years of painful sensory neuropathy of uncertain cause in the lower limbs (3). He had malaise, persistently abnormal liver function tests, and active inflammation and cirrhosis on liver biopsy (Figure).Before beginning anti-HEV therapy, the patient had an undetectable HIV viral load and a CD4 cell count between 30 and 150 cells/mL for the previous 2 years while receiving combination antiretroviral therapy (abacavir–lamivudine once daily and lopinavir–ritonavir twice daily).
authors.forename: Harry R
authors.initials: HR
authors.lastname: Dalton
authors.forename: Frances E
authors.initials: FE
authors.lastname: Keane
authors.forename: Richard
authors.initials: R
authors.lastname: Bendall
authors.forename: Joe
authors.initials: J
authors.lastname: Mathew
authors.forename: Samreen
authors.initials: S
authors.lastname: Ijaz
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D016751:Hepatitis E / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin