title: Severe acute hepatitis E in an HIV infected patient: Successful treatment with ribavirin.
abstract: In industrialized countries, most cases of hepatitis E virus (HEV) infection in humans are autochthonous, mainly through foodborne and zoonotic transmission routes. In Europe, genotype 3 is a cause of acute self-limiting viral hepatitis, but can also be responsible for chronic hepatitis in immunocompromised patients. Ribavirin has been successfully used in the treatment of chronic hepatitis E and in a few cases of severe acute hepatitis E in immunocompetent patients. We report here the case of a 39 year-old man infected with HIV presenting with acute hepatitis E (genotype 3c). Unlike most cases, evolution was severe with a fall of prothrombin time down to 45%. Treatment with ribavirin allowed rapid viral clearance and a gradual normalization of liver function tests.
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
authors.forename: A
authors.initials: A
authors.lastname: Robbins
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
authors.forename: D
authors.initials: D
authors.lastname: Lambert
authors.affiliation: Service de d'hepato-gastroenterologie, CHU Robert Debré, Reims, France.
authors.forename: F
authors.initials: F
authors.lastname: Ehrhard
authors.affiliation: Laboratoire de Virologie Médicale et Moléculaire, CHU Robert Debré, Reims, France.
authors.forename: V
authors.initials: V
authors.lastname: Brodard
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
authors.forename: M
authors.initials: M
authors.lastname: Hentzien
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
authors.forename: D
authors.initials: D
authors.lastname: Lebrun
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Nguyen
authors.affiliation: Laboratoire d'Immunologie, CHU Robert Debré, Reims, France.
authors.forename: T
authors.initials: T
authors.lastname: Tabary
authors.affiliation: Service d'hepato-gastroenterologie, federation digestive, Hôpital Purpan, CHU de Toulouse, Toulouse, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Peron
authors.affiliation: Laboratoire de virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France.
authors.forename: J
authors.initials: J
authors.lastname: Izopet
authors.affiliation: Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France. Electronic address: fbanisadr@chu-reims.fr.
authors.forename: F
authors.initials: F
authors.lastname: Bani-Sadr
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D008111:Liver Function Tests; D008297:Male; D011517:Prothrombin Time; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use*; D019562:Viral Load / Q000187:drug effects
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral; D012254:Ribavirin; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: Acute hepatitis E; HEV; HIV infection; Ribavirin