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Prevalence of active hepatitis E virus infection and efficacy of ribavirin treatment in renal allograft recipients.
Transpl Infect Dis. 2019 Jun; 21(3):e13088.TI

Abstract

BACKGROUND

Hepatitis E virus (HEV) genotype 3 infection frequently progresses to chronic disease with persisting HEV viremia in immunocompromised patients. Here, we evaluated the prevalence of HEV infection in renal allograft recipients and investigated the efficacy and tolerability of ribavirin monotherapy.

METHODS

A total of 947 recipients on average 8.7 years post transplant were screened for anti-HEV IgG, IgM and HEV-RNA. Sixteen HEV-viremic renal allograft recipients were treated with ribavirin for 12 weeks. HEV-RNA concentration, laboratory and clinical parameters were assessed at baseline, during therapy and 12 weeks after treatment cessation. HEV-genotyping was performed in all HEV-viremic patients.

RESULTS

Past HEV infection was detected serologically in 18% of the renal allograft recipients. Ongoing HEV replication was found in 16 recipients (all genotype 3). Unanimously, distinct HEV sequences were revealed in all HEV-viremic patients. At the start of ribavirin treatment, median HEV-RNA viral load was 4.3 × 106 (8000-5.0 × 106) IU/mL. Ninety-four percentage of HEV-infected allograft recipients showed a sustained virological response 12 weeks after treatment cessation. Ribavirin treatment was associated with rapid decrease in liver enzymes and rare occurrence of anemia.

CONCLUSIONS

Prevalence of active HEV infection is important in renal transplant patients without signs of nosocomial infection. Ribavirin treatment was safe and effective.

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Authors+Show Affiliations

Friebus-Kardash J
Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Eisenberger U
Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Ackermann J
Institute for Virology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Kribben A
Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Witzke O
Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Wenzel J
Institute for Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Hospital Regensburg, Regensburg, Germany.
Rohn H
Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.
Fiedler M
Institute for Virology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.

MeSH

AdultAgedAllograftsAntiviral AgentsFemaleGenotypeHepatitis AntibodiesHepatitis EHepatitis E virusHumansImmunocompromised HostKidney TransplantationMaleMiddle AgedPhylogenyPrevalenceRNA, ViralRibavirinTransplantation, HomologousYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30929308

Citation

Friebus-Kardash, Justa, et al. "Prevalence of Active Hepatitis E Virus Infection and Efficacy of Ribavirin Treatment in Renal Allograft Recipients." Transplant Infectious Disease : an Official Journal of the Transplantation Society, vol. 21, no. 3, 2019, pp. e13088.
Friebus-Kardash J, Eisenberger U, Ackermann J, et al. Prevalence of active hepatitis E virus infection and efficacy of ribavirin treatment in renal allograft recipients. Transpl Infect Dis. 2019;21(3):e13088.
Friebus-Kardash, J., Eisenberger, U., Ackermann, J., Kribben, A., Witzke, O., Wenzel, J., Rohn, H., & Fiedler, M. (2019). Prevalence of active hepatitis E virus infection and efficacy of ribavirin treatment in renal allograft recipients. Transplant Infectious Disease : an Official Journal of the Transplantation Society, 21(3), e13088. https://doi.org/10.1111/tid.13088
Friebus-Kardash J, et al. Prevalence of Active Hepatitis E Virus Infection and Efficacy of Ribavirin Treatment in Renal Allograft Recipients. Transpl Infect Dis. 2019;21(3):e13088. PubMed PMID: 30929308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of active hepatitis E virus infection and efficacy of ribavirin treatment in renal allograft recipients. AU - Friebus-Kardash,Justa, AU - Eisenberger,Ute, AU - Ackermann,Jessica, AU - Kribben,Andreas, AU - Witzke,Oliver, AU - Wenzel,Jürgen, AU - Rohn,Hana, AU - Fiedler,Melanie, Y1 - 2019/04/16/ PY - 2019/01/24/received PY - 2019/02/17/revised PY - 2019/03/17/accepted PY - 2019/4/1/pubmed PY - 2019/8/3/medline PY - 2019/4/1/entrez KW - hepatitis E virus infection KW - patients on dialysis KW - renal transplantation KW - ribavirin monotherapy SP - e13088 EP - e13088 JF - Transplant infectious disease : an official journal of the Transplantation Society JO - Transpl Infect Dis VL - 21 IS - 3 N2 - BACKGROUND: Hepatitis E virus (HEV) genotype 3 infection frequently progresses to chronic disease with persisting HEV viremia in immunocompromised patients. Here, we evaluated the prevalence of HEV infection in renal allograft recipients and investigated the efficacy and tolerability of ribavirin monotherapy. METHODS: A total of 947 recipients on average 8.7 years post transplant were screened for anti-HEV IgG, IgM and HEV-RNA. Sixteen HEV-viremic renal allograft recipients were treated with ribavirin for 12 weeks. HEV-RNA concentration, laboratory and clinical parameters were assessed at baseline, during therapy and 12 weeks after treatment cessation. HEV-genotyping was performed in all HEV-viremic patients. RESULTS: Past HEV infection was detected serologically in 18% of the renal allograft recipients. Ongoing HEV replication was found in 16 recipients (all genotype 3). Unanimously, distinct HEV sequences were revealed in all HEV-viremic patients. At the start of ribavirin treatment, median HEV-RNA viral load was 4.3 × 106 (8000-5.0 × 106) IU/mL. Ninety-four percentage of HEV-infected allograft recipients showed a sustained virological response 12 weeks after treatment cessation. Ribavirin treatment was associated with rapid decrease in liver enzymes and rare occurrence of anemia. CONCLUSIONS: Prevalence of active HEV infection is important in renal transplant patients without signs of nosocomial infection. Ribavirin treatment was safe and effective. SN - 1399-3062 UR - https://www.unboundmedicine.com/medline/citation/30929308/Prevalence_of_active_hepatitis_E_virus_infection_and_efficacy_of_ribavirin_treatment_in_renal_allograft_recipients_ L2 - https://doi.org/10.1111/tid.13088 DB - PRIME DP - Unbound Medicine ER -