No clear evidence for an effect of sofosbuvir against hepatitis E virus in organ‐transplant‐patients

Abstract

Recently, Drinane et al. presented the case of a kidney‐pancreas transplant patient with chronic hepatitis E virus (HEV) infection who failed to clear HEV after two courses of ribavirin, and who thereafter eradicated HEV when ribavirin was combined to sofosbuvir. The authors claimed that sofosbuvir has a therapeutic activity against HEV. Unfortunately, they do not provide any robust data to support their conclusion. Indeed, the patient was initially treated with ribavirin (600 mg/d) for 4 months. Treatment was stopped without confirming that HEV RNA became undetectable in the serum and the stools. It has been recently confirmed that the persistence of HEV shedding in the stools at the end of therapy is associated with a higher risk of relapse, and that prolonging the duration of ribavirin therapy allows eradicating HEV.

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