When Should Ribavirin Be Started to Treat Hepatitis E Virus Infection in Transplant Patients?

Hepatitis E virus genotype 3 and capsid protein in the blood and urine of immunocompromised patients

“…A chronic HEV infection was defined as persistent HEV RNA in the blood 3 months after diagnosis, despite the reduced immunosuppressive therapy. 24 Blood and urine samples tested in the study were collected the same day for a standard management, at the acute phase of infection for all patients and at the chronic phase for patients who did not eliminate the virus. Urine samples were cleared by centrifugation (3,650 g/10 minutes).…”

Monitoring hepatitis E virus fecal shedding to optimize ribavirin treatment duration in chronically infected transplant patients

“…1 A shortened surveillance interval (6-month vs. 3-month) after sustained virologic response (SVR) has been suggested in order to diagnose HCC-related tumors at a lower stage and a smaller size, allowing for curative treatment which improves survival and reduces recurrence rates after treatment of HCC. 2 However, the cost-effectiveness of frequent HCC surveillance for individuals after antiviral treatment remains unclear, particularly during the era of direct-acting antiviral therapy when the number of HCV-infected patients who achieve SVR has increased dramatically. Therefore, it is very important to accurately stratify the risks of HCC development in patients who received antiviral treatments using a simple and noninvasive method to guide individualized monitoring.…”

“…1 Ribavirin therapy has been shown to be efficient for treating chronic HEV infection in solid-organ-transplant recipients. 2,3 Eighty percent of patients achieved a sustained virological response 24 weeks (SVR24) after ribavirin cessation. 3 However, the optimal duration of ribavirin therapy is still undetermined.…”

Hepatitis E virus–associated cryoglobulinemia in solid‐organ–transplant recipients

“…In SOT patients, spontaneous clearance is observed in nearly 40% of patients . Chronic HEV infection is defined as persistence of HEV replication beyond 3 months . In patients infected by HEV, the reduction in immunosuppression allows HEV clearance in up to 30% of patients .…”