Treatment of Chronic Hepatitis E in a Patient With HIV Infection
Authors: Harry R. Dalton, Frances E. Keane, Richard Bendall, Joe Mathew, Samreen Ijaz
Journal: Annals of Internal Medicine (2011)

Letters4 October 2011Treatment of Chronic Hepatitis E in a Patient With HIV InfectionHarry R. Dalton, DPhil (Oxon), Frances E. Keane, FRCP, Richard Bendall, FRCPath, Joe Mathew, FRCPath, and Samreen Ijaz, PhDHarry R. Dalton, DPhil (Oxon)From European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Search for more papers by this author, Frances E. Keane, FRCPFrom European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Search for more papers by this author, Richard Bendall, FRCPathFrom European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Search for more papers by this author, Joe Mathew, FRCPathFrom European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Search for more papers by this author, and Samreen Ijaz, PhDFrom European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-7-201110040-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Hepatitis E virus (HEV) infections in immunosuppressed patients can result in chronic hepatitis that rapidly progresses to cirrhosis (1, 2). When immunosuppressed transplant recipitents are treated with pegylated α-interferon and ribavirin, HEV clears and liver histology improves (2). However, we are not aware of reports about how this therapy works in patients with HIV infection.Objective: To describe the clinical and laboratory response to antiviral therapy for chronic HEV infection in a patient also infected with HIV.Case Report: We studied a 48-year-old bisexual male with HIV-1 infection who was chronically infected with HEV genotype 3a and had several ...References1. Kamar N, Selves J, Mansuy JM, Ouezzani L, Péron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358:811-7. [PMID: 18287603] CrossrefMedlineGoogle Scholar2. Kamar N, Abravanel F, Selves J, Garrouste C, Esposito L, Lavayssière L, et al. Influence of immunosuppressive therapy on the natural history of genotype 3 hepatitis-E virus infection after organ transplantation. Transplantation. 2010;89:353-60. [PMID: 20145528] CrossrefMedlineGoogle Scholar3. Dalton HR, Bendall RP, Keane FE, Tedder RS, Ijaz S. Persistent carriage of hepatitis E virus in patients with HIV infection [Letter]. N Engl J Med. 2009;361:1025-7. [PMID: 19726781] CrossrefMedlineGoogle Scholar4. Kamar N, Bendall RP, Peron JM, Cintas P, Prudhomme L, Mansuy JM, et al. Hepatitis E virus and neurologic disorders. Emerg Infect Dis. 2011;17:173-9. [PMID: 21291585] CrossrefMedlineGoogle Scholar5. Kamar N, Izopet J, Cintas P, Garrouste C, Uro-Coste E, Cointault O, et al. Hepatitis E virus-induced neurological symptoms in a kidney-transplant patient with chronic hepatitis. Am J Transplant. 2010;10:1321-4. [PMID: 20346067] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Truro TR1 3HD, United Kingdom; Royal Cornwall Hospital Trust, Truro TR1 3LJ, United Kingdom; and Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, London NW9 5EQ, United Kingdom.Acknowledgment: The authors thank Nassim Kamar and Janice Main for their advice about the treatment given to this patient.Disclosures: None disclosed. 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pathogenQuand rechercher une infection par le virus de l’hépatite E?Community acquired respiratory and gastrointestinal viral infectionsHepatitis EL’hépatite virale E : une maladie émergentePathogenesis and Treatment of Hepatitis E Virus Infection 4 October 2011Volume 155, Issue 7Page: 479-480KeywordsBiopsyBlood plasmaHIV infectionsInflammationInterferonsLiver fibrosisLiver function testsViral load ePublished: 4 October 2011 Issue Published: 4 October 2011 CopyrightCopyright © 2011 by American College of Physicians. 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