title: Ribavirin treatment of acute and chronic hepatitis E: a single-centre experience.
abstract: BACKGROUND
  The role of ribavirin for treatment of severe acute or chronic hepatitis E virus (HEV) infection is not well defined.
  
  
  OBJECTIVE
  To investigate the applicability and efficacy of ribavirin therapy in acute and chronic HEV infections within a large single-centre cohort.
  
  
  METHODS
  Clinical courses of forty-four German HEV-infected individuals were analysed.
  
  
  RESULTS
  In a prospective case series, we observed spontaneous recovery from acute symptomatic HEV-infection in 10/11 immunocompetent individuals. Ribavirin therapy was initiated in one patient with severe acute HEV-genotype-1e infection who rapidly improved liver function and cleared HEV. Of 15 organ transplant recipients with prolonged HEV viraemia, reduction in immunosuppression led to HEV-clearance in three patients, while ribavirin therapy was initiated in 11 subjects. A rapid response with undetectable HEV-RNA occurred in nine subjects. One patient died after experiencing a virological breakthrough associated with ribavirin dose reduction because of severe anaemia.
  
  
  CONCLUSIONS
  Ribavirin is a safe treatment option for HEV infections. However, the optimal dose of ribavirin for the treatment of chronic hepatitis E remains to be determined as treatment failure may occur.
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Pischke
authors.forename: Svenja
authors.initials: S
authors.lastname: Hardtke
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bode
authors.forename: Stephan
authors.initials: S
authors.lastname: Birkner
authors.forename: Christos
authors.initials: C
authors.lastname: Chatzikyrkou
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kauffmann
authors.forename: Christoph L
authors.initials: CL
authors.lastname: Bara
authors.forename: Jens
authors.initials: J
authors.lastname: Gottlieb
authors.forename: Juergen
authors.initials: J
authors.lastname: Wenzel
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006454:Hemoglobins / Q000378:metabolism; D016751:Hepatitis E / Q000188:drug therapy*; D016752:Hepatitis E virus / Q000187:drug effects*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000378:metabolism; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D007074:Immunoglobulin G; D012367:RNA, Viral; D012254:Ribavirin