Tags

Type your tag names separated by a space and hit enter

Chronic Hepatitis E Viral Infection After Liver Transplantation: A Regression of Fibrosis After Antiviral Therapy.
Transplantation. 2017 09; 101(9):2083-2087.T

Abstract

Hepatitis E virus (HEV) infection is increasingly being reported in immunocompromised patients and particularly organ transplant recipients. In this context, HEV infection frequently evolves to chronic infection with a rapid progression of fibrosis to cirrhosis. Ribavirin monotherapy and a minimization of immunosuppression represent the treatment of choice, with a good response rate. However, no data are available on whether treatment can achieve a regression of liver fibrosis in chronic HEV patients. A 57-year-old male patient received a liver transplant for alcoholic cirrhosis and, 6 years later, developed biopsy-proven chronic HEV infection. The patient received different antiviral therapy regimens (pegylated interferon alpha 2b and ribavirin different dosages, and long-term treatment with ribavirin monotherapy still ongoing) but without achieving a sustained virological response. Liver function parameters normalized after 1 month of treatment but without the clearance of HEV. Hepatitis E virus RNA levels also remained detectable in the serum and stools throughout ribavirin monotherapy. No serious adverse events were reported. A gradual regression of liver fibrosis was reported (Metavir A0/F1 in 2015 versus A3/F4 in 2008). Long-term treatment with ribavirin is safe in liver transplant recipients, without achieving HEV sustained virological response, and may induce a biopsy-proven regression of liver fibrosis in a liver transplant recipient with cirrhosis after chronic HEV infection.

Authors+Show Affiliations

1 APHP, Hôpital Pitié-Salpêtrière, Unité Médicale de Transplantation Hépatique, Hépato-Gastro-Enterologie. Hôpital Pitié-Salpêtrière UPMC Paris VI, Boulevard de l'Hôpital, Paris, France. 2 Medicina Traslazionale, Università Piemonte Orientale Amedeo Avogrado, Italy. 3 APHP, Hôpital Pitié-Salpêtrière, Service d'Anatomie et Cytologie Pathologique, Paris, France. 4 APHP, Hôpital Pitié-Salpêtrière, Service d'Anesthésie-Réanimation, Paris, France. 5 APHP, Hôpital Saint Antoine, Service d'Anatomie et Cytologie Pathologique, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28376032

Citation

Mazzola, Alessandra, et al. "Chronic Hepatitis E Viral Infection After Liver Transplantation: a Regression of Fibrosis After Antiviral Therapy." Transplantation, vol. 101, no. 9, 2017, pp. 2083-2087.
Mazzola A, Tran Minh M, Charlotte F, et al. Chronic Hepatitis E Viral Infection After Liver Transplantation: A Regression of Fibrosis After Antiviral Therapy. Transplantation. 2017;101(9):2083-2087.
Mazzola, A., Tran Minh, M., Charlotte, F., Hdiji, A., Bernard, D., Wendum, D., Calmus, Y., & Conti, F. (2017). Chronic Hepatitis E Viral Infection After Liver Transplantation: A Regression of Fibrosis After Antiviral Therapy. Transplantation, 101(9), 2083-2087. https://doi.org/10.1097/TP.0000000000001766
Mazzola A, et al. Chronic Hepatitis E Viral Infection After Liver Transplantation: a Regression of Fibrosis After Antiviral Therapy. Transplantation. 2017;101(9):2083-2087. PubMed PMID: 28376032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Hepatitis E Viral Infection After Liver Transplantation: A Regression of Fibrosis After Antiviral Therapy. AU - Mazzola,Alessandra, AU - Tran Minh,Margherita, AU - Charlotte,Frédéric, AU - Hdiji,Aisha, AU - Bernard,Denis, AU - Wendum,Dominique, AU - Calmus,Yvon, AU - Conti,Filomena, PY - 2017/4/5/pubmed PY - 2017/10/11/medline PY - 2017/4/5/entrez SP - 2083 EP - 2087 JF - Transplantation JO - Transplantation VL - 101 IS - 9 N2 - Hepatitis E virus (HEV) infection is increasingly being reported in immunocompromised patients and particularly organ transplant recipients. In this context, HEV infection frequently evolves to chronic infection with a rapid progression of fibrosis to cirrhosis. Ribavirin monotherapy and a minimization of immunosuppression represent the treatment of choice, with a good response rate. However, no data are available on whether treatment can achieve a regression of liver fibrosis in chronic HEV patients. A 57-year-old male patient received a liver transplant for alcoholic cirrhosis and, 6 years later, developed biopsy-proven chronic HEV infection. The patient received different antiviral therapy regimens (pegylated interferon alpha 2b and ribavirin different dosages, and long-term treatment with ribavirin monotherapy still ongoing) but without achieving a sustained virological response. Liver function parameters normalized after 1 month of treatment but without the clearance of HEV. Hepatitis E virus RNA levels also remained detectable in the serum and stools throughout ribavirin monotherapy. No serious adverse events were reported. A gradual regression of liver fibrosis was reported (Metavir A0/F1 in 2015 versus A3/F4 in 2008). Long-term treatment with ribavirin is safe in liver transplant recipients, without achieving HEV sustained virological response, and may induce a biopsy-proven regression of liver fibrosis in a liver transplant recipient with cirrhosis after chronic HEV infection. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/28376032/Chronic_Hepatitis_E_Viral_Infection_After_Liver_Transplantation:_A_Regression_of_Fibrosis_After_Antiviral_Therapy_ L2 - https://doi.org/10.1097/TP.0000000000001766 DB - PRIME DP - Unbound Medicine ER -