Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
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Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study. / Pischke, Sven; Peron, Jean-Marie; von Wulffen, Moritz; von Felden, Johann; Höner Zu Siederdissen, Christoph; Fournier, Sophie; Lütgehetmann, Marc; Iking-Konert, Christoph; Bettinger, Dominik; Par, Gabriella; Thimme, Robert; Cantagrel, Alain; Lohse, Ansgar W; Wedemeyer, Heiner; de Man, Robert; Mallet, Vincent.
In: VIRUSES-BASEL, Vol. 11, No. 2, 22.02.2019.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
AU - Pischke, Sven
AU - Peron, Jean-Marie
AU - von Wulffen, Moritz
AU - von Felden, Johann
AU - Höner Zu Siederdissen, Christoph
AU - Fournier, Sophie
AU - Lütgehetmann, Marc
AU - Iking-Konert, Christoph
AU - Bettinger, Dominik
AU - Par, Gabriella
AU - Thimme, Robert
AU - Cantagrel, Alain
AU - Lohse, Ansgar W
AU - Wedemeyer, Heiner
AU - de Man, Robert
AU - Mallet, Vincent
PY - 2019/2/22
Y1 - 2019/2/22
N2 - Objectives: Hepatitis E virus (HEV) infection is a pandemic with regional outbreaks, including in industrialized countries. HEV infection is usually self-limiting but can progress to chronic hepatitis E in transplant recipients and HIV-infected patients. Whether other immunocompromised hosts, including rheumatology and internal medicine patients, are at risk of developing chronic HEV infection is unclear. Methods: We conducted a retrospective European multicenter cohort study involving 21 rheumatology and internal medicine patients with HEV infection between April 2014 and April 2016. The underlying diseases included rheumatoid arthritis (n = 5), psoriatic arthritis (n = 4), other variants of chronic arthritis (n = 4), primary immunodeficiency (n = 3), systemic granulomatosis (n = 2), lupus erythematosus (n = 1), Erdheim⁻Chester disease (n = 1), and retroperitoneal fibrosis (n = 1). Results: HEV infection lasting longer than 3 months was observed in seven (33%) patients, including two (40%) patients with rheumatoid arthritis, three (100%) patients with primary immunodeficiency, one (100%) patient with retroperitoneal fibrosis and one (100%) patient with systemic granulomatosis. Patients with HEV infection lasting longer than 3 months were treated with methotrexate without corticosteroids (n = 2), mycophenolate mofetil/prednisone (n = 1), and sirolimus/prednisone (n = 1). Overall, 8/21 (38%) and 11/21 (52%) patients cleared HEV with and without ribavirin treatment, respectively. One patient experienced an HEV relapse after initially successful ribavirin therapy. One patient (5%) was lost to follow-up, and no patients died from hepatic complications. Conclusion: Rheumatology and internal medicine patients, including patients treated with methotrexate without corticosteroids, are at risk of developing chronic HEV infection. Rheumatology and internal medicine patients with abnormal liver tests should be screened for HEV infection.
AB - Objectives: Hepatitis E virus (HEV) infection is a pandemic with regional outbreaks, including in industrialized countries. HEV infection is usually self-limiting but can progress to chronic hepatitis E in transplant recipients and HIV-infected patients. Whether other immunocompromised hosts, including rheumatology and internal medicine patients, are at risk of developing chronic HEV infection is unclear. Methods: We conducted a retrospective European multicenter cohort study involving 21 rheumatology and internal medicine patients with HEV infection between April 2014 and April 2016. The underlying diseases included rheumatoid arthritis (n = 5), psoriatic arthritis (n = 4), other variants of chronic arthritis (n = 4), primary immunodeficiency (n = 3), systemic granulomatosis (n = 2), lupus erythematosus (n = 1), Erdheim⁻Chester disease (n = 1), and retroperitoneal fibrosis (n = 1). Results: HEV infection lasting longer than 3 months was observed in seven (33%) patients, including two (40%) patients with rheumatoid arthritis, three (100%) patients with primary immunodeficiency, one (100%) patient with retroperitoneal fibrosis and one (100%) patient with systemic granulomatosis. Patients with HEV infection lasting longer than 3 months were treated with methotrexate without corticosteroids (n = 2), mycophenolate mofetil/prednisone (n = 1), and sirolimus/prednisone (n = 1). Overall, 8/21 (38%) and 11/21 (52%) patients cleared HEV with and without ribavirin treatment, respectively. One patient experienced an HEV relapse after initially successful ribavirin therapy. One patient (5%) was lost to follow-up, and no patients died from hepatic complications. Conclusion: Rheumatology and internal medicine patients, including patients treated with methotrexate without corticosteroids, are at risk of developing chronic HEV infection. Rheumatology and internal medicine patients with abnormal liver tests should be screened for HEV infection.
KW - Adult
KW - Aged
KW - Antiviral Agents/therapeutic use
KW - Arthritis/complications
KW - Europe
KW - Female
KW - Hepatitis E/drug therapy
KW - Hepatitis, Chronic/drug therapy
KW - Humans
KW - Immunocompromised Host
KW - Immunosuppression
KW - Internal Medicine
KW - Male
KW - Methotrexate/adverse effects
KW - Middle Aged
KW - RNA, Viral
KW - Recurrence
KW - Retrospective Studies
KW - Rheumatology
KW - Ribavirin/therapeutic use
KW - Risk Factors
U2 - 10.3390/v11020186
DO - 10.3390/v11020186
M3 - SCORING: Journal article
C2 - 30813268
VL - 11
JO - VIRUSES-BASEL
JF - VIRUSES-BASEL
SN - 1999-4915
IS - 2
ER -
