Wissenschaftlicher Artikel
Chronic Hepatitis E in rheumatology and internal medicine patients: A retrospective multicenter European cohort study
Pischke, Sven
a
Peron, Jean-Marie
b
Wulffen, Moritz von
Felden, Johann von
Höner zu Siederdissen, Christoph
Fournier, Sophie
Lütgehetmann, Marc
Iking-Konert, Christof
Bettinger, Dominik
1,2,3
Par, Gabriella
Thimme, Robert
1,2
Cantagrel, Alain
Lohse, Ansgar W.
Wedemeyer, Heiner
Man, Robert de
b
Mallet, Vincent
c
Personen-Informationen ausblenden
Erschienen in
Bibliographische Angaben
URN:
urn:nbn:de:bsz:25-freidok-1493456
Sprache:
englisch
Technik / Medizin und Gesundheit
Erscheinungsjahr: 2019
Abstract
-
englisch
Objectives:
Hepatitis E virus (HEV) infection is a pandemic with regional outbreaks, including in industrialized countries. HEV infection is usually self-limiting but can progress to chronic hepatitis E in transplant recipients and HIV-infected patients. Whether other immunocompromised hosts, including rheumatology and internal medicine patients, are at risk of developing chronic HEV infection is unclear.
Methods:
We conducted a retrospective European multicenter cohort study involving 21 rheumatology and internal medicine patients with HEV infection between April 2014 and April 2016. The underlying diseases included rheumatoid arthritis (n = 5), psoriatic arthritis (n = 4), other variants of chronic arthritis (n = 4), primary immunodeficiency (n = 3), systemic granulomatosis (n = 2), lupus erythematosus (n = 1), Erdheim–Chester disease (n = 1), and retroperitoneal fibrosis (n = 1).
Results:
HEV infection lasting longer than 3 months was observed in seven (33%) patients, including two (40%) patients with rheumatoid arthritis, three (100%) patients with primary immunodeficiency, one (100%) patient with retroperitoneal fibrosis and one (100%) patient with systemic granulomatosis. Patients with HEV infection lasting longer than 3 months were treated with methotrexate without corticosteroids (n = 2), mycophenolate mofetil/prednisone (n = 1), and sirolimus/prednisone (n = 1). Overall, 8/21 (38%) and 11/21 (52%) patients cleared HEV with and without ribavirin treatment, respectively. One patient experienced an HEV relapse after initially successful ribavirin therapy. One patient (5%) was lost to follow-up, and no patients died from hepatic complications.
Conclusion:
Rheumatology and internal medicine patients, including patients treated with methotrexate without corticosteroids, are at risk of developing chronic HEV infection. Rheumatology and internal medicine patients with abnormal liver tests should be screened for HEV infection.
Beschreibung
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Bemerkung
This article belongs to the special issue: Hepatitis E virus
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