Autochthonous acute hepatitis E: treatment with sofosbuvir and ribavirin

IntroductionHepatitis E virus (HEV) is an emerging cause of autochthonous-acute-hepatitis and acute-on-chronic-liver-failure in western countries. Treatment is not routinely used, despite ribavirin has a good antiviral effect. In vitro sofosbuvir inhibits HEV replication, but clinical data are lacking.Case reportWe report a case of acute-on-chronic-liver-failure due to HEV treated with sofosbuvir and ribavirin. Thetreatment was capable of rapidly inducing both HCV and HEV viral suppression.ConclusionIn conclusion, although more data are required before firm conclusions could be drawn, the combination of sofosbuvir and ribavirin in not immunosuppressed patients with acute hepatitis E may be able to clear HEV infection.