利巴韦林治疗美国一名健康女性急性戊型肝炎病毒所致肝损伤：病例报告
Ribavirin Treatment in Acute HEV-Induced Liver Injury in a Healthy US Female: A Case Report.
作者信息
Altork Nadera, Fischer Michele P, Cheraghvandi Lukman, Thomas Arul M
机构信息
Department of Internal Medicine, MedStar Health/Georgetown-Washington Hospital Center, Washington, DC, USA.
Department of Gastroenterology and Hepatology, MedStar Georgetown University Hospital, Washington, DC, USA.
出版信息
Case Rep Gastroenterol. 2025 Jun 17;19(1):455-460. doi: 10.1159/000546235. eCollection 2025 Jan-Dec.
INTRODUCTION
Hepatitis E virus (HEV) is a global cause of acute viral hepatitis, for which there is currently no FDA-approved medication. This case report describes a unique instance of a healthy US female presenting with acute HEV, who was treated with ribavirin to address her acute liver injury.
CASE PRESENTATION
A 36-year-old US female, nonpregnant, without liver disease, developed nonspecific symptoms post-travel to Indonesia, leading to acute liver injury with concern for failure. Liver biopsy showed severe hepatocellular necrosis (>50%) with mixed infiltrate; HEV PCR was positive (93,700,000 IU/mL) [Am J Gastroenterol. 2024;119(10S):S2872-3]. After risk-benefit analysis, ribavirin treatment resolved symptoms and normalized biomarkers in a month, avoiding emergency transplantation.
CONCLUSION
HEV infection should be considered in acute liver injury cases in the US, especially with exposure risks. Ribavirin's role in acute cases warrants further study, potentially averting major morbidity and mortality.
引言
戊型肝炎病毒（HEV）是全球急性病毒性肝炎的一个病因，目前尚无美国食品药品监督管理局（FDA）批准的治疗药物。本病例报告描述了一名健康的美国女性患急性戊型肝炎的独特病例，她接受了利巴韦林治疗以应对急性肝损伤。
病例介绍
一名36岁的美国非孕女性，无肝脏疾病，在前往印度尼西亚旅行后出现非特异性症状，导致急性肝损伤并有肝衰竭风险。肝活检显示严重肝细胞坏死（>50%）伴混合浸润；戊型肝炎病毒聚合酶链反应（HEV PCR）呈阳性（93,700,000 IU/mL）[《美国胃肠病学杂志》。2024年；119（10S）：S2872 - 3]。经过风险效益分析，利巴韦林治疗在一个月内缓解了症状并使生物标志物恢复正常，避免了紧急肝移植。
结论
在美国，急性肝损伤病例应考虑戊型肝炎病毒感染，尤其是存在暴露风险时。利巴韦林在急性病例中的作用值得进一步研究，可能避免严重发病和死亡。
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