Severe acute hepatitis E in an HIV infected patient: Successful treatment with ribavirin

J Clin Virol. 2014 Aug;60(4):422-3. doi: 10.1016/j.jcv.2014.05.003. Epub 2014 May 13.


In industrialized countries, most cases of hepatitis E virus (HEV) infection in humans are autochthonous, mainly through foodborne and zoonotic transmission routes. In Europe, genotype 3 is a cause of acute self-limiting viral hepatitis, but can also be responsible for chronic hepatitis in immunocompromised patients. Ribavirin has been successfully used in the treatment of chronic hepatitis E and in a few cases of severe acute hepatitis E in immunocompetent patients. We report here the case of a 39 year-old man infected with HIV presenting with acute hepatitis E (genotype 3c). Unlike most cases, evolution was severe with a fall of prothrombin time down to 45%. Treatment with ribavirin allowed rapid viral clearance and a gradual normalization of liver function tests.

Keywords: Acute hepatitis E; HEV; HIV infection; Ribavirin.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Bilirubin / blood
  • CD4 Lymphocyte Count
  • HIV Infections / complications*
  • HIV Infections / virology
  • Hepatitis Antibodies / blood
  • Hepatitis E / complications
  • Hepatitis E / drug therapy*
  • Hepatitis E / virology
  • Humans
  • Immunocompromised Host
  • Liver Function Tests
  • Male
  • Prothrombin Time
  • RNA, Viral / blood
  • Ribavirin / therapeutic use*
  • Viral Load / drug effects


  • Hepatitis Antibodies
  • RNA, Viral
  • Ribavirin
  • Alanine Transaminase
  • Bilirubin