Efficacy and safety of ribavirin therapy for chronic hepatitis E after kidney transplantation.
Tomoaki YoshidaMasaaki TakamuraRyo GotoSuguru TakeuchiAtsunori TsuchiyaKenya KamimuraMasayuki TasakiYuki NakagawaKazuhide SaitoYoshihiko TomitaShuji TeraiPublished in: Hepatology research : the official journal of the Japan Society of Hepatology (2019)
Hepatitis E virus (HEV) infection has been recognized as an acute condition. However, recent reports have shown that immunocompromised patients, such as those receiving solid-organ transplantation, can develop chronic hepatitis with HEV infection. We report two cases of chronic hepatitis E after kidney transplantation (KT) who were successfully treated with ribavirin monotherapy. Several years after KT, both patients had sustained elevations in the levels of liver enzymes for a period of more than 6 months. Both patients had HEV infection, genotype 3a. Histological studies showed infiltration of inflammatory cells without fibrosis. Treatment included ribavirin monotherapy at a dosage of 600 mg daily for 3 months. One month after therapy initiation, HEV-RNA turned to negative, and remained negative at 24 weeks after ribavirin therapy without severe complications. Although the treatment of chronic hepatitis E is not fully established, ribavirin therapy can be a safe and effective treatment for chronic hepatitis E.
Keyphrases
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- combination therapy
- oxidative stress
- randomized controlled trial
- peritoneal dialysis
- risk factors
- stem cells
- clinical trial
- emergency department
- physical activity
- respiratory failure
- signaling pathway
- mesenchymal stem cells
- acute respiratory distress syndrome
- endoplasmic reticulum stress
- smoking cessation
- cell therapy
- mechanical ventilation
- extracorporeal membrane oxygenation
- aortic dissection
- pi k akt