Acute E hepatitis becomes more frequent in immunocompromised patients. No guidelines are available to date for the management of this infection and of the immunosuppressive treatment.
We report a case of acute E hepatitis treated with ribavirine in a patient known for rheumatoid arthritis and treated with rituximab.
A 51-year-old woman known for rheumatoid arthritis and treated with rituximab was hospitalized for a jaundice secondary to an acute E hepatitis. She was treated with ribavirin 800mg twice a day during 2 months with a good efficacy and tolerance. Finally, 3 months after the acute E hepatitis, she benefited from 2 new 1000mg rituximab infusions because of the rheumatoid arthritis activity. The treatment was well tolerated without acute hepatitis. The follow-up of the HVE infection was realized with HVE PCR in the blood and 8 months after the last infusions, there were no chronic courses or acute hepatitis recurrence.
This case highlights the safety and the efficacy of the reintroduction of rituximab after 2 months of treatment with ribavirin and a negative PCR.