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目的 报道一例异基因造血干细胞移植后出现的利巴韦林难治性慢性戊型肝炎病例，以探讨其临床特点与治疗难点。方法 回顾性分析1例急性髓系白血病异基因造血干细胞移植术后患者的临床资料，包括利巴韦林治疗过程及病毒学应答情况。结果 患者在移植后6个月出现粪便及血清HEV RNA阳性，经利巴韦林治疗1.5个月后血清HEV RNA转阴，但停药1个月即复发。再次接受利巴韦林治疗（剂量由600mg增至800mg）后，血清HEV RNA持续阳性超过1年，表现为利巴韦林难治性感染。结论 在接受强力免疫抑制（尤其钙调磷酸酶抑制剂）的移植患者中，HEV感染易转为慢性且可能对利巴韦林治疗反应不佳。本病例提示需进一步探索HEV慢性化机制及优化抗病毒策略，并加强对此类患者的系统监测与管理。
Abstract：Objective To report a case of ribavirin-refractory chronic hepatitis E virus(HEV) infection following allogeneic hematopoietic stem cell transplantation(allo-HSCT) and to discuss its clinical characteristics and therapeutic challenges. Methods A retrospective analysis was conducted on the clinical data of a patient with acute myeloid leukemia(AML) who underwent allo-HSCT, including the course of HEV infection, ribavirin treatment process, and virological response. Results The patient tested positive for serum HEV RNA 6 months after transplantation. After 1.5 months of ribavirin treatment, the result turned negative, but relapse occurred 1 month after drug withdrawal. Upon re-initiating ribavirin therapy(with the dose increased from 600 mg to 800 mg), serum HEV RNA remained positive for over 1 year, indicating ribavirin-refractory infection. Conclusion In transplant patients receiving strong immunosuppression(particularly calcineurin inhibitors), HEV infection is prone to becoming chronic and may respond poorly to ribavirin treatment. This case highlights the need to further explore the mechanisms of HEV chronicity, optimize antiviral strategies, and strengthen systematic monitoring and management of such patients.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250406
中图分类号:R733.71;R457.7;R512.6
引用信息:
[1]马天羽,邱典雅,王烁杰,等.一例急性髓系白血病异基因造血干细胞移植后继发慢性戊型肝炎的病例报告[J].病毒学报,2026,42(04):1292-1296.DOI:10.13242/j.cnki.bingduxuebao.250406.
基金信息:
北京市医院管理中心“登峰”人才培养计划（项目号：DFL20241803）; 北京市卫健委高层次公共卫生技术人才建设项目（项目号：学科带头人-03-26）~~
2025-12-19
2025
2026-02-27
2026-07-09
2026
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2026-07-09
2026-07-09
2026-07-09