Ribavirin treatment of acute and chronic hepatitis E: a single-centre experience
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Ribavirin treatment of acute and chronic hepatitis E: a single-centre experience. / Pischke, Sven; Hardtke, Svenja; Bode, Ulrike; Birkner, Stephan; Chatzikyrkou, Christos; Kauffmann, Wolfgang; Bara, Christoph L; Gottlieb, Jens; Wenzel, Juergen; Manns, Michael P; Wedemeyer, Heiner.
In: LIVER INT, Vol. 33, No. 5, 05.2013, p. 722-6.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Ribavirin treatment of acute and chronic hepatitis E: a single-centre experience
AU - Pischke, Sven
AU - Hardtke, Svenja
AU - Bode, Ulrike
AU - Birkner, Stephan
AU - Chatzikyrkou, Christos
AU - Kauffmann, Wolfgang
AU - Bara, Christoph L
AU - Gottlieb, Jens
AU - Wenzel, Juergen
AU - Manns, Michael P
AU - Wedemeyer, Heiner
N1 - © 2013 John Wiley & Sons A/S.
PY - 2013/5
Y1 - 2013/5
N2 - BACKGROUND: The role of ribavirin for treatment of severe acute or chronic hepatitis E virus (HEV) infection is not well defined.AIMS: To investigate the applicability and efficacy of ribavirin therapy in acute and chronic HEV infections within a large single-centre cohort.MATERIALS & 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.DISCUSSION: 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.
AB - BACKGROUND: The role of ribavirin for treatment of severe acute or chronic hepatitis E virus (HEV) infection is not well defined.AIMS: To investigate the applicability and efficacy of ribavirin therapy in acute and chronic HEV infections within a large single-centre cohort.MATERIALS & 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.DISCUSSION: 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.
KW - Adult
KW - Cohort Studies
KW - Female
KW - Germany
KW - Hemoglobins/metabolism
KW - Hepatitis E/drug therapy
KW - Hepatitis E virus/drug effects
KW - Humans
KW - Immunoglobulin G/blood
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - RNA, Viral/metabolism
KW - Ribavirin/pharmacology
KW - Statistics, Nonparametric
KW - Treatment Outcome
U2 - 10.1111/liv.12114
DO - 10.1111/liv.12114
M3 - SCORING: Journal article
C2 - 23489973
VL - 33
SP - 722
EP - 726
JO - LIVER INT
JF - LIVER INT
SN - 1478-3223
IS - 5
ER -
