Prevalence of active hepatitis E virus infection and efficacy of ribavirin treatment in renal allograft recipients.
Adult
Aged
Allografts
Antiviral Agents
/ therapeutic use
Female
Genotype
Hepatitis Antibodies
/ blood
Hepatitis E
/ drug therapy
Hepatitis E virus
/ genetics
Humans
Immunocompromised Host
Kidney Transplantation
Male
Middle Aged
Phylogeny
Prevalence
RNA, Viral
/ blood
Ribavirin
/ therapeutic use
Transplantation, Homologous
Young Adult
hepatitis E virus infection
patients on dialysis
renal transplantation
ribavirin monotherapy
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
24
01
2019
revised:
17
02
2019
accepted:
17
03
2019
pubmed:
1
4
2019
medline:
3
8
2019
entrez:
1
4
2019
Statut:
ppublish
Résumé
Hepatitis E virus (HEV) genotype 3 infection frequently progresses to chronic disease with persisting HEV viremia in immunocompromised patients. Here, we evaluated the prevalence of HEV infection in renal allograft recipients and investigated the efficacy and tolerability of ribavirin monotherapy. A total of 947 recipients on average 8.7 years post transplant were screened for anti-HEV IgG, IgM and HEV-RNA. Sixteen HEV-viremic renal allograft recipients were treated with ribavirin for 12 weeks. HEV-RNA concentration, laboratory and clinical parameters were assessed at baseline, during therapy and 12 weeks after treatment cessation. HEV-genotyping was performed in all HEV-viremic patients. Past HEV infection was detected serologically in 18% of the renal allograft recipients. Ongoing HEV replication was found in 16 recipients (all genotype 3). Unanimously, distinct HEV sequences were revealed in all HEV-viremic patients. At the start of ribavirin treatment, median HEV-RNA viral load was 4.3 × 10 Prevalence of active HEV infection is important in renal transplant patients without signs of nosocomial infection. Ribavirin treatment was safe and effective.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis E virus (HEV) genotype 3 infection frequently progresses to chronic disease with persisting HEV viremia in immunocompromised patients. Here, we evaluated the prevalence of HEV infection in renal allograft recipients and investigated the efficacy and tolerability of ribavirin monotherapy.
METHODS
METHODS
A total of 947 recipients on average 8.7 years post transplant were screened for anti-HEV IgG, IgM and HEV-RNA. Sixteen HEV-viremic renal allograft recipients were treated with ribavirin for 12 weeks. HEV-RNA concentration, laboratory and clinical parameters were assessed at baseline, during therapy and 12 weeks after treatment cessation. HEV-genotyping was performed in all HEV-viremic patients.
RESULTS
RESULTS
Past HEV infection was detected serologically in 18% of the renal allograft recipients. Ongoing HEV replication was found in 16 recipients (all genotype 3). Unanimously, distinct HEV sequences were revealed in all HEV-viremic patients. At the start of ribavirin treatment, median HEV-RNA viral load was 4.3 × 10
CONCLUSIONS
CONCLUSIONS
Prevalence of active HEV infection is important in renal transplant patients without signs of nosocomial infection. Ribavirin treatment was safe and effective.
Substances chimiques
Antiviral Agents
0
Hepatitis Antibodies
0
RNA, Viral
0
Ribavirin
49717AWG6K
Types de publication
Journal Article
Langues
eng
Pagination
e13088Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.