【Gastroenterology】应用利巴韦林可有效抑制HEV感染患者的病毒复制

Ribavirin therapy inhibits viral replication in patients with chronic hepatitis E virus infection.

Kamar N, Rostaing L, Abravanel F, Garrouste C, Lhomme S, Esposito L, Basse G, Cointault O, Ribes D, Nogier MB, Alric L, Peron JM, Izopet J.

Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France; INSERM U858, IFR -BMT, CHU Rangueil, Toulouse, France; Université Paul Sabatier, Toulouse, France.

Abstract
BACKGROUND & AIMS: Hepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients. Pegylated alpha-interferon can effectively treat chronic HEV infection after liver transplantation, but is contraindicated for kidney transplantation. We assessed the antiviral effect of ribavirin monotherapy in patients with chronic HEV infection following kidney transplantation.

METHODS: In a pilot study performed at Toulouse University Hospital, 6 patients that received kidney transplants who were positive for HEV RNA (infected with HEV for 36.5 [11-46] months] were given ribavirin monotherapy for 3 months. Ribavirin was given at 600-800 mg/day in 2 separate doses, based on the patient's ability to clear creatinine.

RESULTS: The median serum concentration of HEV RNA at baseline was 5.77 (4.35-7.35) log copies/mL. Three months after ribavirin therapy commenced, HEV RNA was undetectable in serum samples from all patients. A sustained virologic response was observed in 4 patients; the other 2 patients relapsed at 1 and 2 months after ribavirin therapy ended. At the end of the study, all patients had normal levels of alanine and aspartateaminotransferase. Anaemia was the main side effect caused by ribavirin therapy.

CONCLUSION: Ribavirin monotherapy inhibits the replication of HEV in vivo and might induce a sustained virological response in patients with chronic HEV infections. Further studies are required to determine the optimal duration of ribavirin therapy.

PMID: 20708006 [PubMed - as supplied by publisher]