共 21 条
Outcome of Hepatitis E Virus Infection in Patients With Inflammatory Arthritides Treated With Immunosuppressants A French Retrospective Multicenter Study
被引:41
作者:
Bauer, Helene
[1
]
Luxembourger, Cecile
[2
]
Gottenberg, Jacques-Eric
[1
]
Fournier, Sophie
[3
,7
]
Abravanel, Florence
[4
]
Cantagrel, Alain
[2
]
Chatelus, Emmanuel
[1
]
Claudepierre, Pascal
[5
]
Hudry, Christophe
[6
]
Izopet, Jacques
[4
]
Fabre, Sylvie
Lefevre, Guillaume
[8
]
Marguerie, Laurent
[9
,11
]
Martin, Antoine
[6
,10
]
Messer, Laurent
Molto, Anna
Pallot-Prades, Beatrice
[12
]
Pers, Yves-Marie
[7
]
Roque-Afonso, Anne-Marie
[13
]
Roux, Christian
[14
]
Sordet, Christelle
[1
]
Soubrier, Martin
[15
]
Veissier, Claire
[16
]
Wendling, Daniel
[17
]
Peron, Jean-Marie
[3
]
Sibilia, Jean
[1
]
机构:
[1] CHU Hautepierre, Serv Rhumatol, Ctr Reference Malad Autoimmunes Syst Rares, F-67098 Strasbourg, France
[2] CHU Purpan, Serv Rhumatol, Toulouse, France
[3] CHU Purpan, Serv Hepatogastroenterol, Toulouse, France
[4] CHU Purpan, Lab Virol, Toulouse, France
[5] CHU Henri Mondor, Serv Rhumatol, F-94010 Creteil, France
[6] CHU Cochin, Serv Rhumatol, Paris, France
[7] CHU Lapeyronie, Serv Immunol Clin & Therapeut Osteoarticulaire, Montpellier, France
[8] CHRU Lille, Serv Med Interne, Lille, France
[9] Inst Calot, Serv Rhumatol, Berck S Mer, France
[10] CH St Brieuc, Serv Rhumatol, St Brieuc, France
[11] CH Pasteur, Serv Med Interne & Rhumatol, Colmar, France
[12] CHU Bellevue, Serv Rhumatol, St Etienne, France
[13] Hop Paul Brousse, Lab Virol, Villejuif, France
[14] Hop Archet 1, Serv Rhumatol, Nice, France
[15] CHU Clermont Ferrand, Serv Rhumatol, Clermont Ferrand, France
[16] CHU Pellegrin, Serv Rhumatol, Bordeaux, France
[17] CHU Minjoz, Serv Rhumatol, Besancon, France
来源:
关键词:
GENOTYPE;
3;
DIVERSITY;
D O I:
10.1097/MD.0000000000000675
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
The clinical presentation and outcome of hepatitis E virus (HEV) infection in inflammatory rheumatic diseases are unknown. We aimed to investigate the severity of acute HEV infection and the risk of chronic viral replication in patients with inflammatory arthritides treated with immunosuppressive drugs. All rheumatology and internal medicine practitioners belonging to the Club Rhumatismes et Inflammation in France were sent newsletters asking for reports of HEV infection and inflammatory arthritides. Baseline characteristics of patients and the course of HEV infection were retrospectively assessed by use of a standardized questionnaire. From January 2010 to August 2013, we obtained reports of 23 cases of HEV infection in patients with rheumatoid arthritis (n = 11), axial spondyloarthritis (n = 5), psoriatic arthritis (n = 4), other types of arthritides (n = 3). Patients received methotrexate (n = 16), antitumor necrosis factor a agents (n = 10), rituximab (n = 4), abatacept (n = 2), tocilizumab (n = 2), and corticosteroids (n = 10, median dose 6 mg/d, range 2-20). All had acute hepatitis: median aspartate and alanine aminotransferase levels were 679 and 1300 U/L, respectively. Eleven patients were asymptomatic, 4 had jaundice. The HEV infection diagnosis relied on positive PCR results for HEV RNA (n = 14 patients) or anti-HEV IgM positivity (n = 9). Median follow-up was 29 months (range 3-55). Treatment included discontinuation of immunosuppressants for 20 patients and ribavirin treatment for 5. Liver enzyme levels normalized and immunosuppressant therapy could be reinitiated in all patients. No chronic infection was observed. Acute HEV infection should be considered in patients with inflammatory rheumatism and elevated liver enzyme values. The outcome of HEV infection seems favorable, with no evolution to chronic hepatitis or fulminant liver failure.
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