Autochthonous acute hepatitis E: treatment with sofosbuvir and ribavirin

Infection. 2018 Oct;46(5):725-727. doi: 10.1007/s15010-018-1168-7. Epub 2018 Jun 26.

Abstract

Introduction: Hepatitis E virus (HEV) is an emerging cause of autochthonous-acute-hepatitis and acute-on-chronic-liver-failure in western countries. Treatment is not routinely used, despite ribavirin has a good antiviral effect. In vitro sofosbuvir inhibits HEV replication, but clinical data are lacking.

Case report: We report a case of acute-on-chronic-liver-failure due to HEV treated with sofosbuvir and ribavirin. The treatment was capable of rapidly inducing both HCV and HEV viral suppression.

Conclusion: In conclusion, although more data are required before firm conclusions could be drawn, the combination of sofosbuvir and ribavirin in not immunosuppressed patients with acute hepatitis E may be able to clear HEV infection.

Keywords: Acute-on-chronic-liver-failure; Hepatitis C; Hepatitis E; Ribavirin; Sofosbuvir.

Publication types

  • Case Reports

MeSH terms

  • Acute-On-Chronic Liver Failure / diagnosis
  • Acute-On-Chronic Liver Failure / drug therapy
  • Acute-On-Chronic Liver Failure / virology
  • Biomarkers
  • Coinfection
  • Drug Therapy, Combination
  • Fatal Outcome
  • Hepatitis E / diagnosis
  • Hepatitis E / drug therapy*
  • Hepatitis E / transmission*
  • Hepatitis E / virology
  • Humans
  • Liver Function Tests
  • Male
  • Middle Aged
  • Ribavirin / administration & dosage
  • Ribavirin / therapeutic use*
  • Shock, Septic
  • Sofosbuvir / administration & dosage
  • Sofosbuvir / therapeutic use*
  • Treatment Outcome
  • Viral Load

Substances

  • Biomarkers
  • Ribavirin
  • Sofosbuvir