Antiviral therapy in chronic hepatitis E: a systematic review
| Autor: | A. M. Peters van Ton, T. J. G. Gevers, J. P. H. Drenth |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Cirrhosis Side effect viruses Interferon alpha-2 Antiviral Agents Gastroenterology Polyethylene Glycols chemistry.chemical_compound Pegylated interferon Virology Internal medicine Ribavirin Hepatitis E virus medicine Humans Chronic hepatitis E Hepatology business.industry Interferon-alpha virus diseases Organ Transplantation Middle Aged medicine.disease Hepatitis E Recombinant Proteins digestive system diseases Transplant rejection Chronic infection Treatment Outcome Infectious Diseases Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] chemistry Immunology RNA Viral Female business medicine.drug |
| Zdroj: | Journal of Viral Hepatitis, 22, 12, pp. 965-73 Journal of Viral Hepatitis, 22, 965-73 |
| ISSN: | 1352-0504 |
| Popis: | Item does not contain fulltext Hepatitis E viral infection can lead to a chronic infection in immunocompromised patients, resulting in progressive liver disease and cirrhosis. Isolated cases have shown that treatment with ribavirin or pegylated interferon-alpha can result in viral eradication. This systematic review evaluated efficacy and safety of both treatments in chronic hepatitis E. A systematic literature search was performed on PubMed, Web of Science and clinicaltrials.gov for articles and abstracts. The keywords '"Hepatitis E" or HEV' AND 'ribavirin or Rebetol or Copegus' OR 'pegylated interferon OR peginterferon' were combined. The primary outcome was sustained viral response (SVR). Secondary endpoints include rapid viral response (RVR), relapse rates and side effects. Twenty-four studies matched our criteria, representing a total of 105 ribavirin-treated and 8 pegylated interferon-treated patients. The majority of patients had a solid organ transplant. Sixty-four per cent of ribavirin-treated patients achieved a SVR at 6 months after treatment cessation compared to 2/8 peginterferon-treated patients. Ribavirin was relatively well tolerated with the main side effect being anaemia, requiring dose reduction in 28% of patients. Peginterferon leads to acute transplant rejection in 2/8 patients. Ribavirin monotherapy appears to be an effective and safe treatment in all immunocompromised patients with chronic hepatitis E. The use of pegylated interferon in transplant patients may lead to transplant rejection and is not recommended. Therefore, ribavirin should be the antiviral treatment of choice in chronic hepatitis E. |
| Databáze: | OpenAIRE |
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