Journal Article

DKFZ-2023-01329

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Variable outcomes of hepatitis E infections in patients with hemato-oncologic diseases

Ingwersen, V. ; Hofmann, J. ; Muche, M. ; Le Coutre, P. ; Schneider, T. ; Leng, C. ; Burmeister, T. ; Maschmeyer, G. ; Keller, U.DKFZ* ; Schwartz, S.DKFZ*

2023
Karger Basel

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Please use a persistent id in citations: doi:10.1159/000531538

Abstract: Introduction.The hepatitis E virus (HEV) represents an important cause of viral hepatitis and could cause chronicinfections in immunocompromised patients. However, data about immunocompromised patientsother than solid organ transplant recipients are limited.Methods.We identified patients from a laboratory database and retrospectively compiled and analyzed clinicalas well as laboratory data in detail.ResultsOverall, 22 severely immunosuppressed patients, excluding solid organ transplant recipients, wereidentified. Four patients did not experience viral clearance (one without and three despite ribavirintherapy). Three patients acquired the infection after allogeneic hematopoietic stem celltransplantation (alloHSCT) and recovered spontaneously, whereas another patient, infected prior toalloHSCT, developed a chronic infection. Four patients failed to clear HEV, resulting in fatal liver failurein two patients. The CD4+ cell counts increased in all but one patient attaining a sustained virologicalresponse (SVR), as compared to patients with clinical failure. Severe immunoglobulin deficiency didnot appear to obviate the control of HEV. Six of ten (60%) patients with and nine of twelve (75%)patients without ribavirin therapy achieved a SVR.Conclusions.Upfront ribavirin therapy does not appear mandatory in patients without CD4+ lymphopenia, but aprolonged HEV-replication carries the risk of liver failure. Our data suggest that chronic HEV-infectionscould cause T-cell exhaustion, which might be overruled with ribavirin therapy.

Note: 2023;46(7-8):296-302

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Berlin (BE01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2023

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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