Brief communication: case reports of ribavirin treatment for chronic hepatitis E.

Abstract

BACKGROUND: There is currently no accepted treatment of chronic hepatitis E virus (HEV) infection. OBJECTIVE: To report 2 patients in whom ribavirin therapy seemed to alter the natural history of chronic HEV infection. DESIGN: Case reports. SETTING: Hepatology unit of a tertiary care center in France. PATIENTS: A kidney and pancreas transplant recipient and a patient with idiopathic CD4(+) T lymphocytopenia, both with biopsy-proven chronic HEV infection. INTERVENTION: Patients received oral ribavirin, 12 mg/kg of body weight daily for 12 weeks. MEASUREMENTS: Liver function tests, detection of HEV RNA (viremia and stool shedding) by reverse transcriptase polymerase chain reaction, and anti-HEV IgM and IgG antibodies. RESULTS: Both patients had normalized liver function test results after 2 weeks of treatment and cleared HEV after 4 weeks of treatment. Hepatitis E virus RNA remained undetectable in the serum and stools throughout follow-up (3 months and 2 months for the first and second patient, respectively). Side effects were considered mild. LIMITATION: Given the relatively short follow-up, the achievement of HEV eradication could not be claimed. CONCLUSION: Ribavirin is a potentially effective treatment of HEV infection and should be evaluated in patients with chronic HEV infection. PRIMARY FUNDING SOURCE: None.