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Journal Articles Transplantation Year : 2017

Chronic Hepatitis E Viral Infection After Liver Transplantation

Alessandra Mazzola
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Margherita Tran Minh
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Frédéric Charlotte
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Aisha Hdiji
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Denis Bernard
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Yvon Calmus
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Filomena Conti
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Abstract

Hepatitis E virus (HEV) infection is increasingly being reported in immunocompromised patients and particularly organ transplant recipients. In this context, HEV infection frequently evolves to chronic infection with a rapid progression of fibrosis to cirrhosis. Ribavirin monotherapy and a minimization of immunosuppression represent the treatment of choice, with a good response rate. However, no data are available on whether treatment can achieve a regression of liver fibrosis in chronic HEV patients. A 57-year-old male patient received a liver transplant for alcoholic cirrhosis and, 6 years later, developed biopsy-proven chronic HEV infection. The patient received different antiviral therapy regimens (pegylated interferon alpha 2b and ribavirin different dosages, and long-term treatment with ribavirin monotherapy still ongoing) but without achieving a sustained virological response. Liver function parameters normalized after 1 month of treatment but without the clearance of HEV. Hepatitis E virus RNA levels also remained detectable in the serum and stools throughout ribavirin monotherapy. No serious adverse events were reported. A gradual regression of liver fibrosis was reported (Metavir A0/F1 in 2015 versus A3/F4 in 2008). Long-term treatment with ribavirin is safe in liver transplant recipients, without achieving HEV sustained virological response, and may induce a biopsy-proven regression of liver fibrosis in a liver transplant recipient with cirrhosis after chronic HEV infection.
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Dates and versions

hal-03972318 , version 1 (15-03-2023)

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Alessandra Mazzola, Margherita Tran Minh, Frédéric Charlotte, Aisha Hdiji, Denis Bernard, et al.. Chronic Hepatitis E Viral Infection After Liver Transplantation. Transplantation, 2017, 101 (9), pp.2083-2087. ⟨10.1097/TP.0000000000001766⟩. ⟨hal-03972318⟩
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