Bettinger Dominik, Schlabe Stefan, Pischke Sven, Mallmann Michael R, Keyver-Paik Mignon-Denise, Kuhn Walther, Strassburg Christian P, Thimme Robert, Spengler Ulrich
Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
J Clin Transl Hepatol. 2018 Jun 28;6(2):237-240. doi: 10.14218/JCTH.2017.00063. Epub 2018 Jan 18.
Hepatitis E virus infection is usually a self-limited disease. However, during the last years there has been growing evidence for prolonged and chronic infection occurring in patients with immunosuppression. Also patients with malignant and rheumatic diseases have been identified to be at risk for chronic hepatitis E. However, their course and prognosis are not well characterized and there have been no reports of hepatitis E virus infection in patients with gynecological cancer. Here, we report three Caucasian females with breast and ovarian cancers presenting with elevation of aminotransferase levels during anticancer treatment. Although only few or no clinical hints suggested hepatitis E virus infection, the diagnosis of hepatitis E virus infection was confirmed by seroconversion, which might occur with some delay, and/or by polymerase chain reaction. While two patients had a self-limited course, the third patient with a high-risk oncological constellation required ribavirin in order to resume chemotherapy. These cases highlight the need for hepatitis E virus testing in patients with gynecological cancer and elevated aminotransferase levels. Further, these cases show that in selected high-risk patients, ribavirin treatment may be necessary based on the decision of a multidisciplinary team.
戊型肝炎病毒感染通常是一种自限性疾病。然而，在过去几年中，越来越多的证据表明免疫抑制患者会出现持续和慢性感染。此外，已确定患有恶性和风湿性疾病的患者有慢性戊型肝炎的风险。然而，他们的病程和预后尚未得到很好的描述，且尚无妇科癌症患者感染戊型肝炎病毒的报道。在此，我们报告了三名患有乳腺癌和卵巢癌的白种女性，她们在抗癌治疗期间出现转氨酶水平升高。尽管只有很少或没有临床线索提示戊型肝炎病毒感染，但通过血清学转换（可能会有一定延迟）和/或聚合酶链反应确诊了戊型肝炎病毒感染。两名患者病程自限，而第三名具有高风险肿瘤情况的患者需要使用利巴韦林才能恢复化疗。这些病例凸显了对转氨酶水平升高的妇科癌症患者进行戊型肝炎病毒检测的必要性。此外，这些病例表明，在选定的高风险患者中，基于多学科团队的决策，可能需要进行利巴韦林治疗。
