Table 6.

Treatment recommendations proposed for chronic HEV patients after solid organ transplantation.

Therapeutic option	The impact on viral replication	Recommendations
mTOR inhibitors (everolimus, rapamycin)	Accelerates viral replication and increase the viremia level	Dose reduction
Calcineurin inhibitors (tacrolimus, cyclosporine)	Accelerates viral replication and promotes HEV persistence	Dose reduction
Guanosine analog (Ribavirin)	Reduces HEV multiplication and stimulates viral clearance	First line therapy
Cytokines (Pegylated α-Interferon)	Reduces HEV multiplication and stimulates viral clearance	Second-line therapy for cases non-responsive to ribavirin
Nucleotide analog (Sofosbuvir)	Block HEV multiplication in vitro	There are no current recommendations further clinical trials needed