Year 2023 / Volume 115 / Number 5
Letter
Severe hepatitis E in an immunocompetent young female treated with ribavirin

269-270

DOI: 10.17235/reed.2022.9105/2022

Maria Azevedo Silva, André Ruge Gonçalves, Carina Leal, Liliana Eliseu,

Abstract
A healthy 24-year-old woman was admitted to the emergency department with acute hepatitis. She denied traveling, consumption of drugs, herbs, alcohol or medication other than the same oral contraceptive for years. The etiological work-up revealed positive Herpes Simplex Virus (HSV) 1+2 serology (IgG and IgM). Other viral serologies were negative, while Hepatitis E Virus (HEV) serology and viraemia were pending. Liver biopsy showed portal and lobular necroinflammatory activity without specific etiological findings. The remaining work-up was unremarkable. The patient developed jaundice. Acyclovir was started, considering a possible herpetic hepatitis, while waiting for HSV viraemia and immunohistochemistry in the liver biopsy, which later revealed to be negative. Despite therapy, hyperbilirubinemia and liver cytolysis worsened. At this point, HEV serology and viraemia came back positive. Ribavirin was started with rapid clinical and biochemical improvement. Liver enzymes were normal and HEV viraemia was negative after 12 weeks of ribavirin, remaining undetectable 3 months later.
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References
1. Aspinall EJ, Couturier E, Faber M, et al. Hepatitis E virus infection in Europe: Surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015. Eurosurveillance. 2017.
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Azevedo Silva M, Ruge Gonçalves A, Leal C, Eliseu L. Severe hepatitis E in an immunocompetent young female treated with ribavirin. 9105/2022


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Publication history

Received: 30/07/2022

Accepted: 26/08/2022

Online First: 31/08/2022

Published: 05/05/2023

Article Online First time: 32 days

Article editing time: 279 days


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