The Burden of Hepatitis E among Patients with Hematological Malignancies: a Retrospective European Cohort Study
Abstract
BACKGROUND
The burden of hepatitis E virus (HEV) infection has been scarcely reported among patients with haematological malignancy.
METHODS
We conducted a retrospective, multi-centre cohort study across 11 European centres and collected clinical characteristics of 50 patients with haematological malignancy and RNA-positive, clinically overt hepatitis E between April 2014 and March 2017. Primary endpoint was HEV-associated mortality; secondary endpoint was HEV-associated liver-related morbidity.
RESULTS
The most frequent underlying haematological malignancies were aggressive non-Hodgkin lymphoma (NHL) (34%), indolent NHL (iNHL) (24%), and acute leukaemia (36%). Twenty-one (42%) patients had received allogeneic haematopoietic stem cell transplantation (alloHSCT). Death with ongoing hepatitis E occurred in eight (16%) patients, including one with iNHL and one >100 days after alloHSCT in complete remission, and was associated with male sex (p=0.040), cirrhosis (p=0.006) and alloHSCT (p=0.056). Blood-borne transmission of hepatitis E was demonstrated in five (10%) patients, and associated with liver-related mortality in two patients. Hepatitis E progressed to chronic hepatitis in 17 (34%) patients overall, and in ten (47.6%) and six (50%) alloHSCT and iNHL patients, respectively. Hepatitis E was associated with acute or acute-on-chronic liver failure in four (8%) patients with 75% mortality. Ribavirin was administered to 24 (48%) patients and HEV clearance rate was 79.2%.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 50 participants or records.
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