Brief communication: case reports of ribavirin treatment for chronic hepatitis E

Ann Intern Med. 2010 Jul 20;153(2):85-9. doi: 10.7326/0003-4819-153-2-201007200-00257. Epub 2010 Jun 14.


Background: There is currently no accepted treatment of chronic hepatitis E virus (HEV) infection.

Objective: To report 2 patients in whom ribavirin therapy seemed to alter the natural history of chronic HEV infection.

Design: Case reports.

Setting: Hepatology unit of a tertiary care center in France.

Patients: A kidney and pancreas transplant recipient and a patient with idiopathic CD4(+) T lymphocytopenia, both with biopsy-proven chronic HEV infection.

Intervention: Patients received oral ribavirin, 12 mg/kg of body weight daily for 12 weeks.

Measurements: Liver function tests, detection of HEV RNA (viremia and stool shedding) by reverse transcriptase polymerase chain reaction, and anti-HEV IgM and IgG antibodies.

Results: Both patients had normalized liver function test results after 2 weeks of treatment and cleared HEV after 4 weeks of treatment. Hepatitis E virus RNA remained undetectable in the serum and stools throughout follow-up (3 months and 2 months for the first and second patient, respectively). Side effects were considered mild.

Limitation: Given the relatively short follow-up, the achievement of HEV eradication could not be claimed.

Conclusion: Ribavirin is a potentially effective treatment of HEV infection and should be evaluated in patients with chronic HEV infection.

Primary funding source: None.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Antiviral Agents / administration & dosage*
  • Chronic Disease
  • Female
  • Hepatitis E / diagnosis
  • Hepatitis E / drug therapy*
  • Hepatitis E / immunology
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation / immunology
  • Male
  • Middle Aged
  • Pancreas Transplantation / immunology
  • Ribavirin / administration & dosage*
  • T-Lymphocytopenia, Idiopathic CD4-Positive / immunology


  • Antiviral Agents
  • Ribavirin