Risk factors associated with prolonged treatment courses of chronic Hepatitis E

Background and Aims Hepatitis E can lead to chronic courses of infection in immunocompromised patients. We describe here a cohort of 41 patients with chronic HEV (HEV RNA detectable ≥12 weeks). Methods We conducted a retrospective single-center study including patients treated between 2016 and 2024. Clinical, virological, and treatment data were analyzed for predictors of treatment outcome. Patients with more than 12 weeks of ribavirin treatment were defined as ‘complicated’ treatment courses. Results The median patient age was 54 years. Ten patients (24.4%) were female. Transaminases were elevated at time of diagnosis with a median ALT of 118U/l. Median elastography was 6.2 kPa. 4 patients died; 30 patients (81%) required ribavirin treatment. HEV cure after 12 weeks of ribavirin treatment occurred in 16 patients (53.3%), whereas eleven patients (36.6%) needed longer treatment courses or retreatment, three patients (10%) have an ongoing HEV infection. Male sex (p=0.03) and age >50 years (p=0.04) were associated with complicated treatment courses. Both normal and high ALT levels (>200 U/L) at baseline had poorer outcomes, while a BMI <28 kg/m 2 was linked to prolonged viremia. Conclusion We identified factors, associated with an increased risk of viral relapse, warranting close monitoring in these groups. Supplementary Material File (20252212hevkiller.docx) - Download - 555.82 KB Information & Authors Information Version history Copyright This work is licensed under a Non Exclusive No Reuse License.

Authors Metrics & Citations Metrics Article Usage 170views 80downloads Citations Download citation Alexander Killer, Elisa Hellendahl, Smaranda Gliga, et al. Risk factors associated with prolonged treatment courses of chronic Hepatitis E. Authorea. 24 December 2025. DOI: https://doi.org/10.22541/au.176658503.36581938/v1 DOI: https://doi.org/10.22541/au.176658503.36581938/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.