Robbins A, Lambert D, Ehrhard F, Brodard V, Hentzien M, Lebrun D, Nguyen Y, Tabary T, Peron J M, Izopet J, Bani-Sadr F
Service de Médecine Interne et des Maladies Infectieuses et Tropicales, CHU Robert Debré, Reims, France.
Service de d'hepato-gastroenterologie, CHU Robert Debré, Reims, France.
J Clin Virol. 2014 Aug;60(4):422-3. doi: 10.1016/j.jcv.2014.05.003. Epub 2014 May 13.
In industrialized countries, most cases of hepatitis E virus (HEV) infection in humans are autochthonous, mainly through foodborne and zoonotic transmission routes. In Europe, genotype 3 is a cause of acute self-limiting viral hepatitis, but can also be responsible for chronic hepatitis in immunocompromised patients. Ribavirin has been successfully used in the treatment of chronic hepatitis E and in a few cases of severe acute hepatitis E in immunocompetent patients. We report here the case of a 39 year-old man infected with HIV presenting with acute hepatitis E (genotype 3c). Unlike most cases, evolution was severe with a fall of prothrombin time down to 45%. Treatment with ribavirin allowed rapid viral clearance and a gradual normalization of liver function tests.
在工业化国家，人类戊型肝炎病毒（HEV）感染的大多数病例为本地感染，主要通过食源性和人畜共患病传播途径。在欧洲，3型基因型是急性自限性病毒性肝炎的病因，但也可能导致免疫功能低下患者发生慢性肝炎。利巴韦林已成功用于治疗慢性戊型肝炎以及少数免疫功能正常患者的严重急性戊型肝炎。我们在此报告一例39岁感染HIV的男性，表现为急性戊型肝炎（3c基因型）。与大多数病例不同，病情进展严重，凝血酶原时间降至45%。利巴韦林治疗使病毒迅速清除，肝功能检查逐渐恢复正常。
