Miyoshi Masato, Kakinuma Sei, Tanabe Yoko, Ishii Koji, Li Tian-Cheng, Wakita Takaji, Tsuura Yukio, Watanabe Hideki, Asahina Yasuhiro, Watanabe Mamoru, Ikeda Takaaki
Department of Gastroenterology and Hepatology, Yokosuka Kyosai Hospital, Japan.
Intern Med. 2016;55(19):2811-2817. doi: 10.2169/internalmedicine.55.7025. Epub 2016 Oct 1.
Recent case reports have shown that hepatitis E virus (HEV) infection can cause chronic hepatitis in immunosuppressed or immunocompromised patients. A 37-year-old woman suffered from prolonged elevation of aminotransferases after chemotherapy for Burkitt's lymphoma and was diagnosed with chronic hepatitis E due to a transfusion during chemotherapy. After an 8-month administration of ribavirin, complete HEV clearance was not achieved, likely due to prolonged hypogammaglobulinemia. This case indicates that HEV infection should be ruled out during liver dysfunction in immunosuppressed or immunocompromised patients and suggests that an alternative therapeutic strategy for such patients will be needed.
近期的病例报告显示,戊型肝炎病毒(HEV)感染可在免疫抑制或免疫功能低下的患者中导致慢性肝炎。一名37岁女性在接受伯基特淋巴瘤化疗后出现转氨酶长期升高,并因化疗期间输血而被诊断为慢性戊型肝炎。在使用利巴韦林治疗8个月后,未实现HEV的完全清除,可能是由于低丙种球蛋白血症持续时间过长。该病例表明,在免疫抑制或免疫功能低下患者出现肝功能障碍时应排除HEV感染,并提示需要针对此类患者的替代治疗策略。