Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 10 / 18 / 2018

Articles

Ribavirin in Acute Hepatitis E Infection in Patients with Gynecological Cancer: A Case Series

Case Report

Ribavirin in Acute Hepatitis E Infection in Patients with Gynecological Cancer: A Case Series

Dominik Bettinger#,*,1,2, Stefan Schlabe#,3,4, Sven Pischke5, Michael R. Mallmann7, Mignon-Denise Keyver-Paik4,6, Walther Kuhn4,6, Christian P. Strassburg3,4, Robert Thimme‡,1 and Ulrich Spengler‡,3,4

1Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
2Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
3Department of Internal Medicine I, University of Bonn, Bonn, Germany
4Center for Integrated Oncology Cologne/Bonn, Bonn, Germany
5Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
6Department of Obstetrics and Gynecology, University of Bonn, Bonn, Germany
7Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany

#These authors contributed equally to this work.

‡These authors shared equal senior authorship.

*Correspondence to: Dominik Bettinger, Department of Medicine II, Medical Center University of Freiburg, Hugstetter Str. 55, Freiburg 79106, Germany. Tel: +49-761-270-32440, Fax: +49-761-270-32440, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(2):237-240 DOI: 10.14218/JCTH.2017.00063
Received: October 4, 2017 Accepted: December 14, 2017 Published online: January 18, 2018

Abstract

Hepatitis E virus infection is usually a self-limited disease. However, during the last years there has been growing evidence for prolonged and chronic infection occurring in patients with immunosuppression. Also patients with malignant and rheumatic diseases have been identified to be at risk for chronic hepatitis E. However, their course and prognosis are not well characterized and there have been no reports of hepatitis E virus infection in patients with gynecological cancer. Here, we report three Caucasian females with breast and ovarian cancers presenting with elevation of aminotransferase levels during anticancer treatment. Although only few or no clinical hints suggested hepatitis E virus infection, the diagnosis of hepatitis E virus infection was confirmed by seroconversion, which might occur with some delay, and/or by polymerase chain reaction. While two patients had a self-limited course, the third patient with a high-risk oncological constellation required ribavirin in order to resume chemotherapy. These cases highlight the need for hepatitis E virus testing in patients with gynecological cancer and elevated aminotransferase levels. Further, these cases show that in selected high-risk patients, ribavirin treatment may be necessary based on the decision of a multidisciplinary team.

Keywords

Hepatitis E, Gynecological cancer, Liver function test, Chemotherapy, Immunosuppression

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 135-140  [ Html ] [ PDF Full-text ]

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

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