Definition
Hepatitis E is an inflammatory disease of viral origin, which affects the liver. It is a widespread disease especially in developing countries where hygienic conditions are decidedly poor, while it is quite rare in industrialized countries, including Italy.
Causes
Hepatitis E is caused by an RNA virus belonging to the Calicivirus family: the hepatitis E virus or HEV.
The transmission of the virus takes place via the fecal-oral route, in a similar way to what happens for the hepatitis A virus.
More specifically, the virus is transmitted through the consumption of food or water contaminated by the feces of infected individuals; this explains why this disease is widespread especially in countries where there are poor hygienic conditions.
Symptoms
The hepatitis E virus has an incubation period of about 2-9 weeks, after which the symptoms of the disease appear.
The symptoms of hepatitis E are very similar to that of hepatitis A and consist of the onset of malaise, nausea and vomiting, loss of appetite, abdominal and joint pain, dark urine, fatigue, fever and jaundice.
The hepatitis E virus causes an acute infection which, however, can evolve into dangerous fulminant hepatitis. The subjects most at risk for the development of this serious complication are pregnant women, particularly if the infection is contracted during the last trimester of gestation.
Furthermore, in some immunocompromised patients - and particularly in those who have undergone an organ transplant - hepatitis E could also become chronic.
The information on Hepatitis E - Medicines for the Treatment of Hepatitis E is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Hepatitis E - Medicines for the Treatment of " Hepatitis E.
Medicines
There are no specific drugs for the treatment of hepatitis E, since most cases are self-limiting and tend to self-resolve.
However, individuals who contract the virus need to make small lifestyle changes in order to facilitate recovery. More specifically, people with hepatitis E must adopt a balanced and light diet, avoiding fatty foods and alcohol, rest and take plenty of fluids.
Also, patients with hepatitis E should avoid using medications that can further strain the liver.
In immunocompromised patients who have undergone an organ transplant and who contract the hepatitis E virus, it may be necessary to reduce immunosuppressive therapy (used to prevent rejection), in order to allow the immune system to fight the viral infection. .
However, in patients in whom it is not possible or not sufficient to reduce the aforementioned immunosuppressive therapy, the administration of drug therapy may be necessary. Since there are no specific medicines for the treatment of chronic hepatitis E, so-called off-label drugs can be used.
The term "off-label" s "means the use of drugs known and used for some time, for which scientific evidence suggests their use in clinical situations not expressly reported in the therapeutic indications on the package leaflet of the same drug.
Below is an example of an off-label drug that has been used in the therapy against chronic hepatitis E and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
Ribavirin (Ribavirin Three Rivers ®, Ribavirin Teva ®, Rebetol ®): ribavirin is an antiviral drug usually used in the treatment of chronic hepatitis C in combination with other drugs, such as interferon alfa or peginterferon alfa.
However, ribavirin has been used on its own as an off-label drug in the treatment of chronic hepatitis E in immunocompromised patients, at a dose of 600-800 mg per day for a period of three months. The results obtained following this treatment are were encouraging; in fact, over 50% of treated patients were able to reach viral clearance (ie the elimination of the virus from the organism).
