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Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin

Hepatitis E virus (HEV) infection causes chronic hepatitis in solid organ transplant (SOT) recipients. Antiviral therapy consists of three months of ribavirin, although response rates are not optimal. We characterized plasma HEV kinetic patterns in 41 SOT patients during ribavirin therapy. After a m...

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Autores principales: Lhomme, Sebastien, DebRoy, Swati, Kamar, Nassim, Abravanel, Florence, Metsu, David, Marion, Olivier, Dimeglio, Chloé, Cotler, Scott J., Izopet, Jacques, Dahari, Harel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669701/
https://www.ncbi.nlm.nih.gov/pubmed/31323954
http://dx.doi.org/10.3390/v11070630
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author Lhomme, Sebastien
DebRoy, Swati
Kamar, Nassim
Abravanel, Florence
Metsu, David
Marion, Olivier
Dimeglio, Chloé
Cotler, Scott J.
Izopet, Jacques
Dahari, Harel
author_facet Lhomme, Sebastien
DebRoy, Swati
Kamar, Nassim
Abravanel, Florence
Metsu, David
Marion, Olivier
Dimeglio, Chloé
Cotler, Scott J.
Izopet, Jacques
Dahari, Harel
author_sort Lhomme, Sebastien
collection PubMed
description Hepatitis E virus (HEV) infection causes chronic hepatitis in solid organ transplant (SOT) recipients. Antiviral therapy consists of three months of ribavirin, although response rates are not optimal. We characterized plasma HEV kinetic patterns in 41 SOT patients during ribavirin therapy. After a median pharmacological delay of three (range: 0–21) days, plasma HEV declined from a median baseline level of 6.12 (3.53–7.45) log copies/mL in four viral kinetic patterns: (i) monophasic (n = 18), (ii) biphasic (n = 13), (iii) triphasic (n = 8), and (iv) flat-partial response (n = 2). The mean plasma HEV half-life was estimated to be 2.0 ± 0.96 days. Twenty-five patients (61%) had a sustained virological response (SVR) 24 weeks after completion of therapy. Viral kinetic patterns (i)–(iii) were not associated with baseline characteristics or outcome of therapy. A flat-partial response was associated with treatment failure. All patients with a log concentration decrease of plasma HEV at day seven of >15% from baseline achieved SVR. In conclusion, viral kinetic modeling of plasma HEV under ribavirin therapy showed, for the first time, four distinct kinetic profiles, a median pharmacologic delay of three days, and an estimated HEV half-life of two days. Viral kinetic patterns were not associated with response to therapy, with the exception of a flat-partial response.
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spelling pubmed-66697012019-08-08 Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin Lhomme, Sebastien DebRoy, Swati Kamar, Nassim Abravanel, Florence Metsu, David Marion, Olivier Dimeglio, Chloé Cotler, Scott J. Izopet, Jacques Dahari, Harel Viruses Article Hepatitis E virus (HEV) infection causes chronic hepatitis in solid organ transplant (SOT) recipients. Antiviral therapy consists of three months of ribavirin, although response rates are not optimal. We characterized plasma HEV kinetic patterns in 41 SOT patients during ribavirin therapy. After a median pharmacological delay of three (range: 0–21) days, plasma HEV declined from a median baseline level of 6.12 (3.53–7.45) log copies/mL in four viral kinetic patterns: (i) monophasic (n = 18), (ii) biphasic (n = 13), (iii) triphasic (n = 8), and (iv) flat-partial response (n = 2). The mean plasma HEV half-life was estimated to be 2.0 ± 0.96 days. Twenty-five patients (61%) had a sustained virological response (SVR) 24 weeks after completion of therapy. Viral kinetic patterns (i)–(iii) were not associated with baseline characteristics or outcome of therapy. A flat-partial response was associated with treatment failure. All patients with a log concentration decrease of plasma HEV at day seven of >15% from baseline achieved SVR. In conclusion, viral kinetic modeling of plasma HEV under ribavirin therapy showed, for the first time, four distinct kinetic profiles, a median pharmacologic delay of three days, and an estimated HEV half-life of two days. Viral kinetic patterns were not associated with response to therapy, with the exception of a flat-partial response. MDPI 2019-07-09 /pmc/articles/PMC6669701/ /pubmed/31323954 http://dx.doi.org/10.3390/v11070630 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
Lhomme, Sebastien
DebRoy, Swati
Kamar, Nassim
Abravanel, Florence
Metsu, David
Marion, Olivier
Dimeglio, Chloé
Cotler, Scott J.
Izopet, Jacques
Dahari, Harel
Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title_full Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title_fullStr Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title_full_unstemmed Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title_short Plasma Hepatitis E Virus Kinetics in Solid Organ Transplant Patients Receiving Ribavirin
title_sort plasma hepatitis e virus kinetics in solid organ transplant patients receiving ribavirin
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669701/
https://www.ncbi.nlm.nih.gov/pubmed/31323954
http://dx.doi.org/10.3390/v11070630
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