{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:08:02Z","timestamp":1793660882010,"version":"4.5.1"},"reference-count":90,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T00:00:00Z","timestamp":1608422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hepatitis E virus infection can cause chronic hepatitis in immunocompromised patients with significant chance of progressive fibrosis and possibly cirrhosis. The aim of this systematic review was to summarize the efficacy and safety of the various treatment options for chronic hepatitis E. We performed a systematic literature search. The primary outcome measure was a sustained virological response (SVR). Secondary end points were rapid virological response (RVR), relapse rates, side effects and adverse events. Forty\u2010four articles were included with a total of 582 patients. Reduction of immunosuppressive medication induced viral clearance in 55\/174 (32%) of the patients. Meta\u2010analysis of 395 patients showed a pooled SVR rate of 78% (95\u2010CI 72%\u201384%) after ribavirin treatment. Twenty\u2010five per cent of the patients obtained a RVR, whereas a relapse occurred in 18% of the patients. Anaemia during treatment led to dose reduction, use of erythropoietin and\/or blood transfusion in 37% of the patients. A second treatment attempt with ribavirin led to a SVR in 39\/51 (76%) of the patients. Pegylated interferon\u2010alpha was administered to 13 patients and SVR was obtained in 85%. Two patients (15%) suffered from acute transplant rejection during treatment with interferon. In conclusion, reduction of immunosuppressive medication and treatment with ribavirin is safe, generally well tolerated and induced viral clearance in 32% and 78% of patients, respectively. Therefore, ribavirin should be considered as first treatment step for chronic hepatitis E. Treatment with pegylated interferon\u2010alpha increases the risk of transplant rejection and should therefore be administered with great caution.<\/jats:p>","DOI":"10.1111\/jvh.13456","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T22:00:55Z","timestamp":1607637655000},"page":"454-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Treatment for chronic hepatitis E virus infection: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-1434","authenticated-orcid":false,"given":"Myrte","family":"Gorris","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernice M.","family":"van der 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