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Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study

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, includ...

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Autores principales: Pischke, Sven, Peron, Jean-Marie, von Wulffen, Moritz, von Felden, Johann, Höner zu Siederdissen, Christoph, Fournier, Sophie, Lütgehetmann, Marc, Iking-Konert, Christoph, Bettinger, Dominik, Par, Gabriella, Thimme, Robert, Cantagrel, Alain, Lohse, Ansgar W., Wedemeyer, Heiner, de Man, Robert, Mallet, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410237/
https://www.ncbi.nlm.nih.gov/pubmed/30813268
http://dx.doi.org/10.3390/v11020186
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author Pischke, Sven
Peron, Jean-Marie
von Wulffen, Moritz
von Felden, Johann
Höner zu Siederdissen, Christoph
Fournier, Sophie
Lütgehetmann, Marc
Iking-Konert, Christoph
Bettinger, Dominik
Par, Gabriella
Thimme, Robert
Cantagrel, Alain
Lohse, Ansgar W.
Wedemeyer, Heiner
de Man, Robert
Mallet, Vincent
author_facet Pischke, Sven
Peron, Jean-Marie
von Wulffen, Moritz
von Felden, Johann
Höner zu Siederdissen, Christoph
Fournier, Sophie
Lütgehetmann, Marc
Iking-Konert, Christoph
Bettinger, Dominik
Par, Gabriella
Thimme, Robert
Cantagrel, Alain
Lohse, Ansgar W.
Wedemeyer, Heiner
de Man, Robert
Mallet, Vincent
author_sort Pischke, Sven
collection PubMed
description 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.
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spelling pubmed-64102372019-04-01 Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study Pischke, Sven Peron, Jean-Marie von Wulffen, Moritz von Felden, Johann Höner zu Siederdissen, Christoph Fournier, Sophie Lütgehetmann, Marc Iking-Konert, Christoph Bettinger, Dominik Par, Gabriella Thimme, Robert Cantagrel, Alain Lohse, Ansgar W. Wedemeyer, Heiner de Man, Robert Mallet, Vincent Viruses Article 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. MDPI 2019-02-22 /pmc/articles/PMC6410237/ /pubmed/30813268 http://dx.doi.org/10.3390/v11020186 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pischke, Sven
Peron, Jean-Marie
von Wulffen, Moritz
von Felden, Johann
Höner zu Siederdissen, Christoph
Fournier, Sophie
Lütgehetmann, Marc
Iking-Konert, Christoph
Bettinger, Dominik
Par, Gabriella
Thimme, Robert
Cantagrel, Alain
Lohse, Ansgar W.
Wedemeyer, Heiner
de Man, Robert
Mallet, Vincent
Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title_full Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title_fullStr Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title_full_unstemmed Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title_short Chronic Hepatitis E in Rheumatology and Internal Medicine Patients: A Retrospective Multicenter European Cohort Study
title_sort chronic hepatitis e in rheumatology and internal medicine patients: a retrospective multicenter european cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410237/
https://www.ncbi.nlm.nih.gov/pubmed/30813268
http://dx.doi.org/10.3390/v11020186
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