• Nassim Kamar, Lionel Rostaing, Florence Abravanel, Cyril Garrouste, Sebastien Lhomme, Laure Esposito, Grégoire Basse, Olivier Cointault, David Ribes, Marie Béatrice Nogier, Laurent Alric, Jean Marie Peron, and Jacques Izopet.
• Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
• Gastroenterology. 2010 Nov 1; 139 (5): 1612-8.

Background & AimsHepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients. Pegylated α-interferon can effectively treat chronic HEV infection after liver transplantation but is contraindicated for kidney transplantation. We assessed the antiviral effect of ribavirin monotherapy in patients with chronic HEV infection following kidney transplantation.MethodsIn a pilot study performed at Toulouse University Hospital, 6 patients that received kidney transplants who were positive for HEV RNA (infected with HEV for 36.5 months; [range, 11-46 months]) were given ribavirin monotherapy for 3 months. Ribavirin was given at 600-800 mg/day in 2 separate doses, based on the patient's ability to clear creatinine.ResultsMedian serum concentration of HEV RNA at baseline was 5.77 log copies/mL (range, 4.35-7.35 log copies/mL). Three months after ribavirin therapy commenced, HEV RNA was undetectable in serum samples from all patients. A sustained virologic response was observed in 4 patients; the other 2 patients relapsed at 1 and 2 months after ribavirin therapy ended. At the end of the study, all patients had normal levels of alanine and aspartate aminotransferase. Anemia was the main side effect caused by ribavirin therapy.ConclusionsRibavirin monotherapy inhibits the replication of HEV in vivo and might induce a sustained virological response in patients with chronic HEV infections. Further studies are required to determine the optimal duration of ribavirin therapy.Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

37 keywords...

hide…