Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study.
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Authors
Kamar, NassimAbravanel, Florence
Behrendt, Patrick
Hofmann, Jörg
Pageaux, Georges Phillippe
Barbet, Christelle
Moal, Valérie
Couzi, Lionel
Horvatits, Thomas
De Man, Robert A
Cassuto, Elisabeth
Elsharkawy, Ahmed M
Riezebos-Brilman, Annelies
Scemla, Anne
Hillaire, Sophie
Donnelly, Mhairi C
Radenne, Sylvie
Sayegh, Johnny
Garrouste, Cyril
Dumortier, Jérôme
Glowaki, François
Matignon, Marie
Coilly, Audrey
Figueres, Lucile
Mousson, Christiane
Minello, Anne
Dharancy, Sébastien
Rerolle, Jean Philippe
Lebray, Pascal
Etienne, Isabelle
Perrin, Peggy
Choi, Mira
Marion, Olivier
Izopet, Jacques
Issue Date
2020-09-01Submitted date
2019-03-23
Metadata
Show full item recordAbstract
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.Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaPubMed ID
31793638Type
ArticleLanguage
enEISSN
1537-6591ae974a485f413a2113503eed53cd6c53
10.1093/cid/ciz953
Scopus Count
The following license files are associated with this item:
- Creative Commons
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