期刊
CURRENT OPINION IN INFECTIOUS DISEASES
卷 27, 期 4, 页码 303-308出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QCO.0000000000000074
关键词
chronic HEV; clinical evidence; experimental evidence; immunosuppressive medication
资金
- Netherlands Organization for Scientific Research (NWO/ZonMw) [916-13-032]
- European Association for the Study of the Liver (EASL)
- Dutch Digestive Foundation (MLDS) [CDG 1304]
- Daniel den Hoed Foundation
- China Scholarship Council [201207720007]
Purpose of review Solid-organ recipients infected with hepatitis E virus (HEV) bear an extremely high risk of developing chronic hepatitis, although this virus only causes acute infection in the general population. Immunosuppressive medication universally used after transplantation to prevent organ rejection appears to be a main risk factor for developing chronic infection. This review aims to overview and emphasize the current clinical and experimental evidence regarding the key implications of immunosuppressants in chronic hepatitis E. Recent findings Over 60% of organ recipients who are infected with HEV develop chronic hepatitis. Immunosuppressant treatment after transplantation was identified as a key risk factor. Therefore, dose reduction or even withdrawal of immunosuppressants is considered as the first intervention strategy to achieve viral clearance in these patients. Otherwise, ribavirin, as an off-label medication, is considered as an antiviral treatment, with compelling outcomes observed so far. Interestingly, in addition to a common immunosuppression property that can favour HEV infection in general, different types of immunosuppressants may exert differential impacts on the infection course in patients. Furthermore, potential interaction may exist between particular immunosuppressant and ribavirin. With the recent development of a cell culture system for HEV, experimental research has been initiated to investigate how immunosuppressive drugs interact with HEV infection. Summary On the basis of the current evidence, it remains impossible to define an optimal immunosuppressive protocol for these HEV-infected patients. However, the realization of this clinical issue and the initiation of translational research using cell culture models of HEV have been represented as milestones in this field.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据