Pegylated interferon may be considered in chronic viral hepatitis E resistant to ribavirin in kidney transplant recipients.
Drug Resistance, Viral
/ drug effects
Hepatitis E
/ drug therapy
Hepatitis E virus
/ drug effects
Hepatitis, Chronic
/ drug therapy
Humans
Interferon-alpha
/ therapeutic use
Kidney Transplantation
Male
Middle Aged
Polyethylene Glycols
/ therapeutic use
Recombinant Proteins
/ therapeutic use
Remission Induction
Ribavirin
/ therapeutic use
Sustained Virologic Response
Transplant Recipients
Treatment Outcome
Hepatitis E
Interferon
Kidney transplantation
Rejection
Ribavirin
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
16 Jul 2020
16 Jul 2020
Historique:
received:
13
02
2020
accepted:
29
06
2020
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
28
8
2020
Statut:
epublish
Résumé
Hepatitis E virus (HEV) may be resistant to immunosuppression reduction and ribavirin treatment in kidney transplant recipients because of mutant strains and severe side effects of ribavirin which conduct to dose reduction. Sofosbuvir efficacy is controversial. Peg-interferon 2 alpha (PEG-IFN) is currently contraindicated due to a high risk of acute humoral and cellular rejection. The present study assessed, for the first time, the effect of PEG-IFN in a kidney transplant recipient infected with HEV. The patient had chronic active HEV that was resistant to immunosuppression reduction and optimal ribavirin treatment. He developed significant liver fibrosis. PEG-IFN was administered for 10 months, and it was well tolerated and did not induce rejection. A sustained virological response was obtained. We conclude that prolonged treatment with PEG-IFN in kidney transplant recipients infected with HEV could be considered as a salvage option.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis E virus (HEV) may be resistant to immunosuppression reduction and ribavirin treatment in kidney transplant recipients because of mutant strains and severe side effects of ribavirin which conduct to dose reduction. Sofosbuvir efficacy is controversial. Peg-interferon 2 alpha (PEG-IFN) is currently contraindicated due to a high risk of acute humoral and cellular rejection. The present study assessed, for the first time, the effect of PEG-IFN in a kidney transplant recipient infected with HEV.
CASE PRESENTATION
METHODS
The patient had chronic active HEV that was resistant to immunosuppression reduction and optimal ribavirin treatment. He developed significant liver fibrosis. PEG-IFN was administered for 10 months, and it was well tolerated and did not induce rejection. A sustained virological response was obtained.
CONCLUSIONS
CONCLUSIONS
We conclude that prolonged treatment with PEG-IFN in kidney transplant recipients infected with HEV could be considered as a salvage option.
Identifiants
pubmed: 32677900
doi: 10.1186/s12879-020-05212-2
pii: 10.1186/s12879-020-05212-2
pmc: PMC7367388
doi:
Substances chimiques
Interferon-alpha
0
Recombinant Proteins
0
Polyethylene Glycols
3WJQ0SDW1A
Ribavirin
49717AWG6K
peginterferon alfa-2a
Q46947FE7K
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
522Références
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