Hepatitis E case series: A UK experience.

The incidence of hepatitis E continues to increase and in immunocompromised patients can lead to chronic infection. Management of hepatitis E has evolved over time, with the first step being a reduction of immunosuppression followed by treatment with ribavirin. The European Association for the Study of Liver guidelines support treatment with ribavirin although the optimum dose and regime is unknown.

Chronic genotype 1 hepatitis E infection from immunosuppression for ileo-colonic Crohn's disease.

We report a case of a 33-year-old man with a background of longstanding ileo-colonic Crohn's disease and primary sclerosing cholangitis. Following a trip to India he developed diarrhoea which was treated as an exacerbation of Crohn's disease. Liver tests became chronically deranged after increasing immunosuppression, which comprised mercaptopurine, adalimumab and prednisolone.