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Journal Articles Clinical Infectious Diseases Year : 2020

Ribavirin for Hepatitis E Virus Infection After Organ Transplantation

1 Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation
2 CPTP - Centre de Physiopathologie Toulouse Purpan
3 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
4 UT3 - Université Toulouse III - Paul Sabatier
5 MHH - Medizinische Hochschule Hannover = Hannover Medical School
6 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
7 Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
8 Service de néphrologie et immunologie clinique [CHRU Tours]
9 MEPHI - Microbes évolution phylogénie et infections
10 APHM - Assistance Publique - Hôpitaux de Marseille
11 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
12 CHU Bordeaux
13 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
14 Erasmus MC - Erasmus University Medical Center [Rotterdam]
15 CHU Nice - Centre Hospitalier Universitaire de Nice
16 University Hospitals Birmingham [Birmingham, Royaume-Uni]
17 UMCG - University Medical Center Groningen [Groningen]
18 Réseau CENTAURE
19 Hôpital Foch [Suresnes]
20 Royal Infirmary of Edinburgh
21 Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL]
22 CHU Angers - Centre Hospitalier Universitaire d'Angers
23 CHU Clermont-Ferrand
24 Hôpital Edouard Herriot [CHU - HCL]
25 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
26 IMRB - Institut Mondor de Recherche Biomédicale
27 Hôpital Paul Brousse
28 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
29 Service de néphrologie (CHU de Dijon)
30 Service d'Hépato-Gastro-Entérologie (CHU de Dijon)
31 Hôpital Claude Huriez [Lille]
32 LIRIC - Lille Inflammation Research International Center - U 995
33 Service de Néphrologie, Dialyse, Transplantations [CHU Limoges]
34 CHU Pitié-Salpêtrière [AP-HP]
35 CHU Rouen
36 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
37 Département de Néphrologie et Transplantation d'organes [CHU Toulouse]
38 Service de virologie et d'immunologie biologique
Lionel Couzi
  • Function : Author
  • PersonId : 951011
Anne Scemla
  • Function : Author
Cyril Garrouste
Jérôme Dumortier
Audrey Coilly
Isabelle Etienne
  • Function : Author
Marion Olivier
Jacques Izopet
J Bellière
  • Function : Author
L Espostio
  • Function : Author
A Hebral
  • Function : Author
L Lavayssière
  • Function : Author
S Lhomme
  • Function : Author
J Mansuy
  • Function : Author
H Wedemeyer
  • Function : Author
P Nickel
  • Function : Author
K Stefic
  • Function : Author
L D’alteroche
  • Function : Author
S Bufton
  • Function : Author
C Ramière
  • Function : Author
S Pischke
  • Function : Author
E Todesco
  • Function : Author
R Sberro Soussan
  • Function : Author
C Legendre
  • Function : Author
V. Mallet
  • Function : Author
I Johannessen
  • Function : Author
K Simpson
  • Function : Author

Abstract

Background: Ribavirin is currently recommended for treating chronic hepatitis E virus (HEV) infection. This retrospective European multicenter study aimed to assess the sustained virological response (SVR) in a large cohort of solid organ transplant (SOT) recipients with chronic HEV infection treated with ribavirin monotherapy (N = 255), to identify the predictive factors for SVR, and to evaluate the impact of HEV RNA mutations on virological response. Methods: Data from 255 SOT recipients with chronic HEV infection from 30 European centers were analyzed. Ribavirin was given at the median dose of 600 (range, 29-1200) mg/day (mean, 8.6 ± 3.6 mg/kg/day) for a median duration of 3 (range, 0.25-18) months. Results: After a first course of ribavirin, the SVR rate was 81.2%. It increased to 89.8% when some patients were offered a second course of ribavirin. An increased lymphocyte count at the initiation of therapy was a predictive factor for SVR, while poor hematological tolerance of ribavirin requiring its dose reduction (28%) and blood transfusion (15.7%) were associated with more relapse after ribavirin cessation. Pretreatment HEV polymerase mutations and de novo mutations under ribavirin did not have a negative impact on HEV clearance. Anemia was the main adverse event. Conclusions: This large-scale retrospective study confirms that ribavirin is highly efficient for treating chronic HEV infection in SOT recipients and shows that the predominant HEV RNA polymerase mutations found in this study do not affect the rate of HEV clearance.This large-scale retrospective study that included 255 solid organ transplant recipients confirms that ribavirin is highly efficient for treating chronic hepatitis E virus (HEV) infection and shows that HEV RNA polymerase mutations do not play a role in HEV clearance.
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Dates and versions

hal-02465266 , version 1 (30-05-2024)

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Nassim Kamar, Florence Legrand-Abravanel, Patrick Behrendt, Jörg Hofmann, Georges Phillippe Pageaux, et al.. Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study. Clinical Infectious Diseases, 2020, 71 (5), pp.1204-1211. ⟨10.1093/cid/ciz953⟩. ⟨hal-02465266⟩
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