Three-month pegylated interferon-alpha-2a therapy for chronic hepatitis E virus infection in a haemodialysis patient

Nephrol Dial Transplant. 2010 Aug;25(8):2792-5. doi: 10.1093/ndt/gfq282. Epub 2010 May 20.

Abstract

Hepatitis E virus (HEV) can induce chronic hepatitis in immunosuppressed patients. There is no established treatment for HEV infection. Pegylated interferon-alpha-2a (Peg-IFN-alpha-2a) has been successfully used for treating HEV infection in liver transplant patients with chronic hepatitis. A kidney transplant patient with chronic HEV infection evolved to end-stage kidney disease and started haemodialysis. Three months after immunosuppressive therapy was stopped, HEV RNA was still detected both in serum and in stools. Before considering a retransplantation, we decided to initiate Peg-IFN-alpha-2a therapy to eradicate the virus. A 3-month course of Peg-IFN-alpha-2a was scheduled, and the latter was started at the weekly dose of 135 microg. Serum HEV RNA became negative by Week 3 of Peg-IFN-alpha-2a therapy, and remained negative until the last follow-up, i.e. 6 months after anti-viral therapy was stopped. Hence, we report the first known case of a 3-month course of Peg-IFN-alpha-2a inducing a sustained virological response in this HEV-positive and RNA-positive haemodialysis patient who had failed to be cleared of the virus after immunosuppressant withdrawal.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Hepatitis E / drug therapy*
  • Hepatitis E virus*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation / immunology
  • Male
  • Nephritis, Hereditary / surgery
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / virology
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins
  • Renal Dialysis*
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Immunosuppressive Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • peginterferon alfa-2a