Department of Internal Medicine IV, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena, Germany.
J Int Med Res. 2023 Jul;51(7):3000605231187941. doi: 10.1177/03000605231187941.
Hepatitis E virus (HEV) infections are common, self-limiting causes of acute viral hepatitis. This study aimed to analyze hepatic injury, viremia, and chronicity rates in patients with acute HEV infection receiving immunosuppressive (IS) therapy taking into account ribavirin treatment.
In this retrospective, single-center, observational study, we analyzed the disease course of 25 non-cirrhotic patients receiving IS therapy who were diagnosed with acute HEV viremia. Forty-four patients with acute HEV viremia without IS therapy were controls.
Demographics, symptoms at presentation, and extrahepatic manifestations were not different between patients with and without IS therapy, but liver injury at presentation was less severe in patients with IS therapy. Among the patients with IS therapy, 18 (72%) received ribavirin for a median of 56 days. Sustained viral clearance was observed in 21 patients with IS therapy, whereas 3 patients relapsed after ribavirin, and 1 patient had viral persistence. Among patients with sustained viral clearance, there was a longer duration of viremia in patients with IS therapy than in those without.
In this cohort of non-cirrhotic patient with IS, early treatment with ribavirin for acute HEV infection did not improve viral clearance rates, but may have shortened the duration of viremia.
戊型肝炎病毒（HEV）感染是常见的、自限性的急性病毒性肝炎病因。本研究旨在分析接受免疫抑制（IS）治疗的急性 HEV 感染患者的肝损伤、病毒血症和慢性率，并考虑利巴韦林治疗。
在这项回顾性、单中心、观察性研究中，我们分析了 25 例非肝硬化接受 IS 治疗且诊断为急性 HEV 病毒血症的患者的疾病过程。44 例未接受 IS 治疗的急性 HEV 病毒血症患者作为对照。
IS 治疗患者和未接受 IS 治疗患者的人口统计学、发病时的症状和肝外表现无差异，但 IS 治疗患者的肝损伤程度较轻。在接受 IS 治疗的患者中，有 18 例（72%）接受了利巴韦林治疗，中位疗程为 56 天。IS 治疗的 21 例患者持续病毒清除，3 例患者在利巴韦林后复发，1 例患者病毒持续存在。在持续病毒清除的患者中，IS 治疗患者的病毒血症持续时间更长。
在本队列中，非肝硬化的 IS 患者早期接受利巴韦林治疗急性 HEV 感染并未提高病毒清除率，但可能缩短了病毒血症的持续时间。
