Hepatitis E medical therapy: Difference between revisions
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For developing counties, pregnant women with hepatitis E should be treated, however, a specific treatment regimen has not been established. [[Ribavirin]] might be indicated for the treatment of these patients. Despite the [[teratogenic]] contra-indications of [[ribavirin]], the risks of [[HEV infection]] for the mother and fetus may outweigh the [[teratogenicity]] risks of the drug.<ref name="pmid22549046">{{cite journal| author=Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J et al.| title=Hepatitis E. | journal=Lancet | year= 2012 | volume= 379 | issue= 9835 | pages= 2477-88 | pmid=22549046 | doi=10.1016/S0140-6736(11)61849-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22549046 }} </ref> | For developing counties, pregnant women with hepatitis E should be treated, however, a specific treatment regimen has not been established. [[Ribavirin]] might be indicated for the treatment of these patients. Despite the [[teratogenic]] contra-indications of [[ribavirin]], the risks of [[HEV infection]] for the mother and fetus may outweigh the [[teratogenicity]] risks of the drug.<ref name="pmid22549046">{{cite journal| author=Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J et al.| title=Hepatitis E. | journal=Lancet | year= 2012 | volume= 379 | issue= 9835 | pages= 2477-88 | pmid=22549046 | doi=10.1016/S0140-6736(11)61849-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22549046 }} </ref> | ||
===Chronic Hepatitis E=== | |||
Chronic HEV infection often occurs in transplanted patients. For this group, three therapeutic options are available: | |||
* Reduction of [[immunosupression]] | |||
* [[Pegylated interferon-α]] | |||
* [[Ribavirin]] | |||
==References== | ==References== | ||
Revision as of 14:49, 25 August 2014
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Hepatitis E Microchapters |
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Hepatitis E medical therapy On the Web |
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American Roentgen Ray Society Images of Hepatitis E medical therapy |
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Risk calculators and risk factors for Hepatitis E medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Medical Therapy
As no specific therapy is capable of altering the course of acute hepatitis E infection, prevention is the most effective approach against the disease. Hospitalization is required for fulminant hepatitis and should be considered for infected pregnant women.[1][2][3]
Acute Hepatitis E
The majority of hepatitis E cases in immunocompetent patients are self-limited. Some patients may require symptomatic treatment, however, HEV infection resolves spontaneously in most cases.[4]
Patients with pre-existing liver conditions, may require treatment with ribavirin. A patient who received treatment with ribavirin showed a normalization of bilirubin levels and a decrease in transaminases.[5][6][6]
For developing counties, pregnant women with hepatitis E should be treated, however, a specific treatment regimen has not been established. Ribavirin might be indicated for the treatment of these patients. Despite the teratogenic contra-indications of ribavirin, the risks of HEV infection for the mother and fetus may outweigh the teratogenicity risks of the drug.[7]
Chronic Hepatitis E
Chronic HEV infection often occurs in transplanted patients. For this group, three therapeutic options are available:
- Reduction of immunosupression
References
- ↑ "Hepatitis E" (PDF).
- ↑ Fields, Bernard (2013). Fields virology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781451105636.
- ↑ LastName, FirstName (2011). Lippincott's guide to infectious diseases. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. ISBN 1605479756.
- ↑ Wedemeyer H, Pischke S, Manns MP (2012). "Pathogenesis and treatment of hepatitis e virus infection". Gastroenterology. 142 (6): 1388–1397.e1. doi:10.1053/j.gastro.2012.02.014. PMID 22537448.
- ↑ Péron JM, Dalton H, Izopet J, Kamar N (2011). "Acute autochthonous hepatitis E in western patients with underlying chronic liver disease: a role for ribavirin?". J Hepatol. 54 (6): 1323–4, author reply 1324-5. doi:10.1016/j.jhep.2011.01.009. PMID 21281681.
- ↑ 6.0 6.1 Gerolami R, Borentain P, Raissouni F, Motte A, Solas C, Colson P (2011). "Treatment of severe acute hepatitis E by ribavirin". J Clin Virol. 52 (1): 60–2. doi:10.1016/j.jcv.2011.06.004. PMID 21764632.
- ↑ Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J; et al. (2012). "Hepatitis E." Lancet. 379 (9835): 2477–88. doi:10.1016/S0140-6736(11)61849-7. PMID 22549046.