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Ribavirin Treatment in Acute HEV-Induced Liver Injury in a Healthy US Female: A Case Report
Nadera Altork1, Michele P Fischer2, Lukman Cheraghvandi3
1Department of Internal Medicine, MedStar Health/Georgetown-Washington Hospital Center, Washington, DC, USA.
Case Reports in Gastroenterology
|June 18, 2025
Summary
Hepatitis E virus (HEV) infection can cause severe liver injury. This case report shows ribavirin effectively treated a healthy woman with acute HEV, resolving her symptoms and preventing liver failure.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis E virus (HEV) is a significant global cause of acute viral hepatitis.
- Currently, no FDA-approved antiviral medication exists for HEV treatment.
- This case highlights a unique presentation of acute HEV in a healthy US adult.
Observation:
- A 36-year-old healthy US female presented with nonspecific symptoms following travel to Indonesia.
- She developed acute liver injury with severe hepatocellular necrosis (>50%) and positive HEV PCR (93,700,000 IU/mL).
- The patient was nonpregnant and had no prior history of liver disease.
Findings:
- Treatment with ribavirin was initiated after a thorough risk-benefit analysis.
- Within one month, ribavirin treatment led to symptom resolution and normalization of liver biomarkers.
- The patient successfully avoided the need for emergency liver transplantation.
Implications:
- HEV infection should be considered in the differential diagnosis of acute liver injury in the US, particularly with relevant travel history.
- This case suggests ribavirin may be a viable therapeutic option for severe acute HEV infection.
- Further research into ribavirin's efficacy in acute HEV cases is warranted to potentially reduce morbidity and mortality.
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