In addition to the authors the following collaborators helped to generate the data (Hannover HEV-Study-Group; Collaborators): G. Beutel10, N. Cieplik1, F. Lehner3, R. Raupach1, M. Darnedde1, B. Bremer1, N. Malek1*, A. Haverich2, 7, W. Gwinner2,5, M. Cornberg1, W. Jilg9.
Ribavirin treatment of acute and chronic hepatitis E: a single-centre experience
Article first published online: 13 MAR 2013
© 2013 John Wiley & Sons A/S
Volume 33, Issue 5, pages 722–726, May 2013
How to Cite
Liver Int. 2013: 33: 722–726
*Present address: Department of Gastroenterology, University Hospital of Tuebingen, Tuebingen, Germany
- Issue published online: 7 APR 2013
- Article first published online: 13 MAR 2013
- Accepted manuscript online: 28 JAN 2013 01:16AM EST
- Manuscript Accepted: 20 DEC 2012
- Manuscript Received: 20 SEP 2012
- German Federal Ministry of Education and Research. Grant Number: 01EO0802
- Robert Koch Institute on hepatitis E. Grant Number: 1362-1097
- acute liver failure;
- hepatitis E;
The role of ribavirin for treatment of severe acute or chronic hepatitis E virus (HEV) infection is not well defined.
To investigate the applicability and efficacy of ribavirin therapy in acute and chronic HEV infections within a large single-centre cohort.
Materials & Methods
Clinical courses of forty-four German HEV-infected individuals were analysed.
In a prospective case series, we observed spontaneous recovery from acute symptomatic HEV-infection in 10/11 immunocompetent individuals. Ribavirin therapy was initiated in one patient with severe acute HEV-genotype-1e infection who rapidly improved liver function and cleared HEV. Of 15 organ transplant recipients with prolonged HEV viraemia, reduction in immunosuppression led to HEV-clearance in three patients, while ribavirin therapy was initiated in 11 subjects. A rapid response with undetectable HEV-RNA occurred in nine subjects. One patient died after experiencing a virological breakthrough associated with ribavirin dose reduction because of severe anaemia.
Ribavirin is a safe treatment option for HEV infections. However, the optimal dose of ribavirin for the treatment of chronic hepatitis E remains to be determined as treatment failure may occur.