Ribavirin for severe acute hepatitis E virus infection

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Madureira, S (Author) Other; Soares, N (Author) Other; Lino, R (Author) Other; Almeida, C (Author) Other; Ceia, F (Author) FMUP; Silva-Pinto, A (Author) FMUP; Albuquerque, I (Author) Other; Almeida, J (Author) Other

Journal

Title: Gazzetta Medica Italiana Archivio per le Scienze Mediche

Vol. 181

Pages: 680-683

ISSN: 0393-3660

Publisher: EDIZIONI MINERVA MEDICA

Indexing

ISI Web of Knowledge - 0 Citations

Scopus

Other information

Authenticus ID: P-00X-QMS

DOI: 10.23736/s0393-3660.21.04605-2

Abstract (EN): Hepatitis E virus (HEV) infection was thought to be a rare cause of acute hepatitis, exclusive of low-income countries, but it has been increasingly reported in countries with better sanitary conditions. Although it does not stand as one of the most common causes of acute hepatitis, this case reminds us of taking it into consideration when investigating the etiology of one. We report the case of a 46-year-old male presented to the emergency department due to fatigue, nausea, coluria and pale stools. He had been recently hospitalized twice due to orbital cellulitis and received several antimicrobials. His blood work was notable for prominent elevation of aminotransferases and bilirubin. He had no encephalopathy or coagulopa-thy. He was admitted to the hospital on a N-acetylcysteine protocol for acute hepatitis of unknown cause. Auto-immune, viral, and genetic causes like Wilson's disease were investigated and excluded and a liver biopsy was performed. Later, the clinical picture was found to be related to acute hepatitis E virus infection and there were prominent inflammatory and necrotic features on the histological samples obtained. Usually, treatment of these patients resides on supportive care measures, but since clinical and laboratorial improvement was not obtained, it was decided to start ribavirin, a therapy usually reserved for high-risk patients. Symptoms ameliorated 48 hours after initiating ribavirin and aminotransferases and bilirubin normalized over the following weeks. This case not only highlights the relevance of taking into consid-eration Hepatitis virus E, even outside endemic regions, on the diagnostic approach of a patient with acute hepatitis of unknown source. It also reports a successful therapeutical approach with a drug whose reports in literature are scarce and whose benefit in patients with severe acute hepatitis or HEV-induced liver failure is still uncertain.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 4