Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study.

Kamar, Nassim and Abravanel, Florence and Behrendt, Patrick and Hofmann, Jörg and Pageaux, Georges Phillippe and Barbet, Christelle and Moal, Valérie and Couzi, Lionel and Horvatits, Thomas and De Man, Robert A and Cassuto, Elisabeth and Elsharkawy, Ahmed M and Riezebos-Brilman, Annelies and Scemla, Anne and Hillaire, Sophie and Donnelly, Mhairi C and Radenne, Sylvie and Sayegh, Johnny and Garrouste, Cyril and Dumortier, Jérôme and Glowaki, François and Matignon, Marie and Coilly, Audrey and Figueres, Lucile and Mousson, Christiane and Minello, Anne and Dharancy, Sébastien and Rerolle, Jean Philippe and Lebray, Pascal and Etienne, Isabelle and Perrin, Peggy and Choi, Mira and Marion, Olivier and Izopet, Jacques (2019) Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. ISSN 1537-6591.

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Abstract

BACKGROUND

Ribavirin is currently recommended for treating chronic hepatitis E virus (HEV) infection. This retrospective European multicenter study aimed to assess the sustained virological response (SVR) in a large cohort of solid organ transplant (SOT) recipients with chronic HEV infection treated with ribavirin monotherapy (N = 255), to identify the predictive factors for SVR, and to evaluate the impact of HEV RNA mutations on virological response.

METHODS

Data from 255 SOT recipients with chronic HEV infection from 30 European centers were analyzed. Ribavirin was given at the median dose of 600 (range, 29-1200) mg/day (mean, 8.6 ± 3.6 mg/kg/day) for a median duration of 3 (range, 0.25-18) months.

RESULTS

After a first course of ribavirin, the SVR rate was 81.2%. It increased to 89.8% when some patients were offered a second course of ribavirin. An increased lymphocyte count at the initiation of therapy was a predictive factor for SVR, while poor hematological tolerance of ribavirin requiring its dose reduction (28%) and blood transfusion (15.7%) were associated with more relapse after ribavirin cessation. Pretreatment HEV polymerase mutations and de novo mutations under ribavirin did not have a negative impact on HEV clearance. Anemia was the main adverse event.

CONCLUSIONS

This large-scale retrospective study confirms that ribavirin is highly efficient for treating chronic HEV infection in SOT recipients and shows that the predominant HEV RNA polymerase mutations found in this study do not affect the rate of HEV clearance.This large-scale retrospective study that included 255 solid organ transplant recipients confirms that ribavirin is highly efficient for treating chronic hepatitis E virus (HEV) infection and shows that HEV RNA polymerase mutations do not play a role in HEV clearance.

Item Type: Article
Subjects: WC Communicabable diseases
Divisions: Clinical Support > Infectious Diseases
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Depositing User: Mr Philip O'Reilly
Date Deposited: 10 Dec 2019 10:52
Last Modified: 10 Dec 2019 10:52
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2667

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