Hepatitis E medical therapy: Difference between revisions
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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.<ref name=WHO>{{cite web | title = Hepatitis E | url = http://www.who.int/csr/disease/hepatitis/HepatitisE_whocdscsredc2001_12.pdf }}</ref><ref>{{cite book | last = Fields | first = Bernard | title = Fields virology | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia | year = 2013 | isbn = 9781451105636 }}</ref><ref>{{cite book | last = LastName | first = FirstName | title = Lippincott's guide to infectious diseases | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2011 | isbn = 1605479756 }}</ref> | 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.<ref name=WHO>{{cite web | title = Hepatitis E | url = http://www.who.int/csr/disease/hepatitis/HepatitisE_whocdscsredc2001_12.pdf }}</ref><ref>{{cite book | last = Fields | first = Bernard | title = Fields virology | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia | year = 2013 | isbn = 9781451105636 }}</ref><ref>{{cite book | last = LastName | first = FirstName | title = Lippincott's guide to infectious diseases | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2011 | isbn = 1605479756 }}</ref> | ||
===Acute Hepatitis E=== | ===Acute Hepatitis E=== | ||
The majority of hepatitis E cases are self-limited, | 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 patients.<ref name="pmid22537448">{{cite journal| author=Wedemeyer H, Pischke S, Manns MP| title=Pathogenesis and treatment of hepatitis e virus infection. | journal=Gastroenterology | year= 2012 | volume= 142 | issue= 6 | pages= 1388-1397.e1 | pmid=22537448 | doi=10.1053/j.gastro.2012.02.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22537448 }} </ref> | ||
Patients with pre-existing liver conditions may require treatment with [[ribavirin]].<ref name="pmid21281681">{{cite journal| author=Péron JM, Dalton H, Izopet J, Kamar N| title=Acute autochthonous hepatitis E in western patients with underlying chronic liver disease: a role for ribavirin? | journal=J Hepatol | year= 2011 | volume= 54 | issue= 6 | pages= 1323-4; author reply 1324-5 | pmid=21281681 | doi=10.1016/j.jhep.2011.01.009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21281681 }} </ref><ref name="pmid21764632">{{cite journal| author=Gerolami R, Borentain P, Raissouni F, Motte A, Solas C, Colson P| title=Treatment of severe acute hepatitis E by ribavirin. | journal=J Clin Virol | year= 2011 | volume= 52 | issue= 1 | pages= 60-2 | pmid=21764632 | doi=10.1016/j.jcv.2011.06.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21764632 }} </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> | 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 Hepatitis E=== | ||
Revision as of 14:31, 25 August 2014
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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 patients.[4]
Patients with pre-existing liver conditions may require treatment with ribavirin.[5][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
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.
- ↑ 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.