Novelty Statement
In this paper, Hepatitis E that developed while on immunosuppressive
therapy could be safely treated with ribavirin and continued
chemotherapy. This study provides clinicians with new information and
suggestions for improving the clinical outcome of patients with HEV
infection.
Abstract
The main differentials in cases of sudden elevation of hepatic enzyme
levels during immunochemotherapy are reactivation of hepatitis B virus
or drug-induced liver injury. Here, we report a case of acute liver
injury caused by hepatitis E virus (HEV) during chemotherapy for
malignant lymphoma, wherein the patient was successfully treated and
completed chemotherapy.
A 57-year-old woman visited her local doctor because she felt light and
tired. The patient underwent lower gastrointestinal endoscopy and was
diagnosed with a malignant lymphoma of the small intestine (diffuse
large B-cell lymphoma). The patient had a history of oral consumption of
undercooked pork liver to improve anemia and was diagnosed with acute
hepatitis E. Since the patient responded to chemotherapy, she was
treated with single-agent ribavirin while continuing chemotherapy,
resulting in a sustained virological response.
Even during treatment with immunosuppressive drugs, if appropriate
treatment for hepatitis E can be administered, the patient can be fully
treated without interruption. The patient was able to complete
chemotherapy adequately without interruption of treatment, which was a
clinically beneficial result.
Keywords: Chemotherapy, Hepatitis E virus, Ribavirin