Ribavirin for Severe Acute and Chronic Hepatitis E Virus Infection.

Inclusion Criteria: * Age equal or greater than 18 years. * To comply with any of the following diagnoses: * chronic Hepatitis E: HEV RNA detectable in patients with elevated transaminase levels for at least 6 months and / or HEV RNA detectable in two separated determinations by an interval of six months . * severe acute Hepatitis E: alanine aminotransferase (ALT) levels greater than 10 times the normal limit, with HEV RNA positive, and signs of acute liver injury (International normalized ratio(INR\> 1.5)); or with extrahepatic manifestations or liver failure in patients with previous liver disease. * Signed informed consent Exclusion Criteria: * Terminal illness with a expected life expectancy of less than 6 months * Patients with contraindications for treatment with Ribavirin: * pregnancy or lactation. * Severe hepatic impairment or decompensated cirrhosis. * hemoglobinopathies (thalassemia, sickle cell anemia). * history of severe pre-existing cardiac disease, including unstable heart disease.