Full Genome Sequencing And Characterization Of A New Hav Strain Type 1b Circulating In Italy

prednisolone with tacrolimus (N=4) or cyclosporine (N=1) with or without mycophenolate mofetil. The 4 lung transplant recipients were treated with ribavirin (RBV) and followed up for up to 19 months. Results: HEV infection became apparent 4 [1–9] (median [range]) months after transplantation. All patients had elevated liver enzymes at diagnosis of HEV infection (mean ALT: 79 [62–110] U/l; [range]) and were infected with HEV genotype 3. Liver biopsy revealed presence of cirrhosis in 3 patients (Metavir fibrosis stage 1 and 2 in the remaining two). During RBV treatment ALT values normalized in all, but HEV-RNA became undetectable in only 2 patients. One Patient achieved a SVR, the other relapsed. The kidney-transplanted patient presented with liver failure and died prior to initiation of ribavirin treatment. Conclusions: Chronic HEV infection may have a rapid fibrosis progression and is an important cause of liver related morbidity in patients after transplantation. Treatment with ribavirin results in viral suppression and biochemical normalization, although it might not be successful in all patients on the long run.