[Autochthonous hepatitis E virus in Southeastern France. 2 cases]. / Hépatite virale E autochtone dans le sud-est de la France. Deux observations.

INTRODUCTION: Hepatitis E virus is endemic in developing countries where it is especially lethal among pregnant women. As the circulation of goods and people grows between these countries and the industrialized nations, this virus is emerging as a cause of imported acute hepatitis in the latter, where authentic autochthonous cases also exist. OBSERVATIONS: We report two cases observed in Marseille, in men aged 27 and 81 years; no mode of contamination was detected, and both outcomes were positive. DISCUSSION: This virus is circulating in non-endemic areas (as shown by its seroprevalence, which ranges from 0.4 to 2.6%, its identification in urban sewage, and the autochthonous cases reported). This dissemination, combined with its high mortality rate, even outside pregnancy (up to 12%), show the need for systematic consideration of and an early search for the often-fleeting presence of the virus and of IgM and IgG type serum antibodies in plasma and (when necessary) feces in cases of acute hepatitis, because of their often transient nature. Prophylaxis is based on improving water hygiene and is thus more difficult in industrialized countries where the level of hygiene is already high, especially when no risk factors can be identified in the autochthonous cases. Recombinant vaccines are under development.

[Curative short term treatment of chronic viral C hepatitis]. / Traitement curatif de courte durée de l'hépatite chronique virale C.

INTRODUCTION: Chronic viral C hepatitis can be cured by shorter treatment than recommended. It is illustrated by our two case reports. CASES: We report two cases of chronic viral C hepatitis cured by short therapy with interferon standard alone in one case and the combination of pegylated-interferon and ribavirin in the second case. Genotype was undetermined for one patient and 3a for the other. DISCUSSION: Excepted genotyping and early testing of viral load decrease during treatment (12th week), we lack early predictive factors of sustained response that could help avoid prolonged, poorly tolerated therapy in future non-responders. These observations show that the treatment duration of chronic viral C hepatitis can be shortened in selected patients, who should be identified as soon as possible after the beginning of the treatment.