Clinical features of hepatitis E infections in patients with hematologic disorders
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Clinical features of hepatitis E infections in patients with hematologic disorders. / Ghandili, Susanne; Lindhauer, Cecilia; Pischke, Sven; Zur Wiesch, Julian Schulze; Von Kroge, Philipp H; Polywka, Susanne; Bokemeyer, Carsten; Fiedler, Walter; Kröger, Nicolaus; Ayuk, Francis; Adjallé, Raissa; Modemann, Franziska.
In: HAEMATOLOGICA, Vol. 107, No. 12, 01.12.2022, p. 2870-2883.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical features of hepatitis E infections in patients with hematologic disorders
AU - Ghandili, Susanne
AU - Lindhauer, Cecilia
AU - Pischke, Sven
AU - Zur Wiesch, Julian Schulze
AU - Von Kroge, Philipp H
AU - Polywka, Susanne
AU - Bokemeyer, Carsten
AU - Fiedler, Walter
AU - Kröger, Nicolaus
AU - Ayuk, Francis
AU - Adjallé, Raissa
AU - Modemann, Franziska
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Hepatitis E virus is increasingly being reported to cause chronic infection in immunocompromised patients. However, less is known about patients with an underlying hematologic disease. In particular, the impact of hepatitis E infection on oncological therapy has been poorly described. In this retrospective single-center study, we analyzed 35 hematologic patients with hepatitis E, including 20 patients under active oncological treatment and 15 patients who were in the posttreatment follow-up or under active surveillance. The primary aim was to describe the clinical courses with particular focus on any hepatitis E-related therapy modifications of cancer-directed therapy. In the majority (60%) of patients who were under active oncological treatment, hepatitis E-related therapy modifications were made, and 25% of deaths were due to progression of the hematologic disease. In patients receiving concomitant oncological treatment, no hepatitis Erelated deaths occurred. In contrast, two patients in the follow-up group died from hepatitis E-associated acute-onchronic liver failure. Chronic hepatitis E was observed in 34% of all cases and 43% received ribavirin therapy; of those, 27% achieved a sustained virological response. CD20-directed therapy was the only independent risk factor for developing chronic hepatitis E. We conclude that CD20-directed treatment at any time point is a risk factor for developing chronic hepatitis E. Nevertheless, since mortality from the progression of hematologic disease was higher than hepatitis E-related mortality, we suggest careful case-by-case decisions on modifications of cancer treatment. Patients in the posttreatment follow-up phase may also suffer from severe courses and hepatitis E chronicity occurs as frequently as in patients undergoing active therapy.
AB - Hepatitis E virus is increasingly being reported to cause chronic infection in immunocompromised patients. However, less is known about patients with an underlying hematologic disease. In particular, the impact of hepatitis E infection on oncological therapy has been poorly described. In this retrospective single-center study, we analyzed 35 hematologic patients with hepatitis E, including 20 patients under active oncological treatment and 15 patients who were in the posttreatment follow-up or under active surveillance. The primary aim was to describe the clinical courses with particular focus on any hepatitis E-related therapy modifications of cancer-directed therapy. In the majority (60%) of patients who were under active oncological treatment, hepatitis E-related therapy modifications were made, and 25% of deaths were due to progression of the hematologic disease. In patients receiving concomitant oncological treatment, no hepatitis Erelated deaths occurred. In contrast, two patients in the follow-up group died from hepatitis E-associated acute-onchronic liver failure. Chronic hepatitis E was observed in 34% of all cases and 43% received ribavirin therapy; of those, 27% achieved a sustained virological response. CD20-directed therapy was the only independent risk factor for developing chronic hepatitis E. We conclude that CD20-directed treatment at any time point is a risk factor for developing chronic hepatitis E. Nevertheless, since mortality from the progression of hematologic disease was higher than hepatitis E-related mortality, we suggest careful case-by-case decisions on modifications of cancer treatment. Patients in the posttreatment follow-up phase may also suffer from severe courses and hepatitis E chronicity occurs as frequently as in patients undergoing active therapy.
U2 - 10.3324/haematol.2022.280853
DO - 10.3324/haematol.2022.280853
M3 - SCORING: Journal article
C2 - 35770534
VL - 107
SP - 2870
EP - 2883
JO - HAEMATOLOGICA
JF - HAEMATOLOGICA
SN - 0390-6078
IS - 12
ER -