Chronic hepatitis E in a heart transplant patient: sofosbuvir and ribavirin regimen not fully effective

Eve Todesco; Alessandra Mazzola; Sepideh Akhavan; Florence Abravanel; Thierry Poynard; Anne-Marie Roque-Afonso; Gilles Peytavin; Anne-Geneviève Marcelin; Yvon Calmus; Lucien Lecuyer; Romain Guillemain; Filomena Conti

doi:10.3851/IMP3227

Chronic hepatitis E in a heart transplant patient: sofosbuvir and ribavirin regimen not fully effective

Antivir Ther. 2018;23(5):463-465. doi: 10.3851/IMP3227.

Authors

Eve Todesco^{1

2}, Alessandra Mazzola³, Sepideh Akhavan^{2

4}, Florence Abravanel^{5

6}, Thierry Poynard⁷, Anne-Marie Roque-Afonso⁸, Gilles Peytavin^{9

10}, Anne-Geneviève Marcelin^{1

2}, Yvon Calmus³, Lucien Lecuyer¹¹, Romain Guillemain¹², Filomena Conti³

Affiliations

¹ Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
² Department of Virology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
³ APHP, Hôpital Pitié-Salpêtrière, Unité Médicale de Transplantation Hépatique, Hépato-Gastro-Enterologie, UPMC Paris VI, Boulevard de l'Hôpital, Paris, France.
⁴ Sorbonne Universités, UPMC Univ Paris 06, CIMI-Paris UMRS CR7, Inserm U1135, PVI Team, Paris, France.
⁵ CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, Toulouse, France.
⁶ INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France.
⁷ Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938 and Institute of Cardiometabolism and Nutrition (ICAN), INSERM, Paris, France.
⁸ AP-HP, Hôpital Paul Brousse, Virologie, Univ Paris-Sud, INSERM U1193, Villejuif, France.
⁹ Pharmaco-Toxicology Department, Bichat-Claude Bernard Hospital, APHP, Paris, France.
¹⁰ Université Paris Diderot, Sorbonne Paris Cité, IAME, INSERM UMR 1137, Paris, France.
¹¹ Université René Descartes, Service de Chirurgie Cardio-Vasculaire, Assistance Publique-hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.
¹² Unité Fonctionnelle de Transplantation Thoracique, Pole Cardiovasculaire - Néphrologie - Hypertension - Diabète, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.

PMID: 29504509
DOI: 10.3851/IMP3227

Abstract

Hepatitis E virus (HEV) can induce chronic infections in the case of immunosuppression, which are sometimes not cured with ribavirin. Furthermore, sofosbuvir is a highly potent inhibitor of HCV polymerase and was shown to inhibit HEV genotype-3 replication in vitro. We report here the outcome of sofosbuvir/ribavirin therapy on a chronic HEV infection in a heart transplant recipient non-responder to ribavirin. After 24 weeks, the regimen failed to cure the persistent HEV infection, highlighting the need of therapeutic options for HEV-infected immunosuppressed patients.

Publication types

Case Reports

MeSH terms

Antiviral Agents / therapeutic use*
Cardiomyopathy, Dilated / physiopathology
Cardiomyopathy, Dilated / surgery
Chronic Disease
Drug Therapy, Combination
Heart Transplantation*
Hepatitis E / drug therapy*
Hepatitis E / immunology*
Hepatitis E / pathology
Hepatitis E / virology
Hepatitis E virus / drug effects
Hepatitis E virus / immunology
Hepatitis E virus / pathogenicity
Humans
Immunocompromised Host*
Immunosuppressive Agents / administration & dosage
Immunosuppressive Agents / adverse effects
Male
Middle Aged
Ribavirin / therapeutic use*
Sofosbuvir / therapeutic use*
Treatment Failure

Substances

Antiviral Agents
Immunosuppressive Agents
Ribavirin
Sofosbuvir