Hepatitis E

Hepatitis E
Hepatitis E virus
SpecialtyInfectious disease, Hepatology
SymptomsNausea, jaundice[1]
ComplicationsLiver failure[1]
CausesHepatitis E virus (HEV)[1]
Diagnostic methodBlood test[1]
Differential diagnosisHepatitis A[2]
TreatmentRest, ribavirin (if chronic)[1]
Frequency28 million worldwide (2013)[3]

Hepatitis E is inflammation of the liver caused by infection with the hepatitis E virus (HEV);[4][5] it is a type of viral hepatitis.[6] Hepatitis E has mainly a fecal-oral transmission route that is similar to hepatitis A, although the viruses are unrelated.[7][8][9] HEV is a positive-sense, single-stranded, nonenveloped, RNA icosahedral virus and one of five known human hepatitis viruses: A, B, C, D, and E.

Like hepatitis A, hepatitis E usually follows an acute and self-limiting course of illness (the condition is temporary and the individual recovers) with low death rates in resource-rich areas; however, it can be more severe in pregnant women and people with a weakened immune system, with substantially higher death rates. In pregnant women, especially in the third trimester, the disease is more often severe and is associated with a clinical syndrome called fulminant liver failure, with death rates around 20%.[8][10][11] Whereas pregnant women may have a rapid and severe course, organ transplant recipients who receive medications to weaken the immune system and prevent organ rejection can develop a slower and more persistent form called chronic hepatitis E,[12] which is so diagnosed after 3 months of continuous viremia.[13] HEV can be clustered genetically into 8 genotypes, and genotypes 3 and 4 tend to be the ones that cause chronic hepatitis in the immunosuppressed.[14][15][16]

In 2017, hepatitis E was estimated to affect more than 19 million people.[3] Those most commonly at risk of HEV are men aged 15 to 35 years of age.[17] A preventive vaccine (HEV 239) is approved for use in China.[18]

The virus was discovered in 1983 by researchers investigating an outbreak of unexplained hepatitis among Soviet soldiers serving in Afghanistan.[17] The earliest well-documented epidemic of hepatitis E occurred in 1955 in New Delhi and affected tens of thousands of people (hepatitis E virus was identified as the etiological agent at fault retrospectively through testing of stored samples).[19]

  1. ^ a b c d e "Hepatitis E | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 24 June 2018.
  2. ^ "Hepatitis A Differential Diagnoses". emedicine.medscape.com. Retrieved 27 July 2019.
  3. ^ a b James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. (10 November 2018). "Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017". Lancet. 392 (10159): 1789–1858. doi:10.1016/S0140-6736(18)32279-7. ISSN 0140-6736. PMC 6227754. PMID 30496104.
  4. ^ "Hepatitis E: Background, Etiopathophysiology, Epidemiology". medscape.com. Medscape. 2019.
  5. ^ Kamar N, Dalton HR, Abravanel F, Izopet J (2014). "Hepatitis E Virus Infection". Clinical Microbiology Reviews. 27 (1): 116–138. doi:10.1128/CMR.00057-13. ISSN 0893-8512. PMC 3910910. PMID 24396139.
  6. ^ "Hepatitis (Viral) NIDDK". The National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 19 June 2020.
  7. ^ "What is hepatitis?". www.who.int. WHO. Retrieved 17 April 2019.
  8. ^ a b "Hepatitis E". www.who.int. WHO. Retrieved 17 April 2019.
  9. ^ Weston D, Burgess A, Roberts S (2016). Infection Prevention and Control at a Glance. John Wiley & Sons. p. 12. ISBN 978-1-118-97355-4.
  10. ^ Cite error: The named reference pregn was invoked but never defined (see the help page).
  11. ^ Cite error: The named reference cdchev was invoked but never defined (see the help page).
  12. ^ Zhou X, de Man RA, de Knegt RJ, Metselaar HJ, Peppelenbosch MP, Pan Q (2013). "Epidemiology and management of chronic hepatitis E infection in solid organ transplantation: a comprehensive literature review". Rev. Med. Virol. 23 (5): 295–304. doi:10.1002/rmv.1751. PMID 23813631. S2CID 41424447.
  13. ^ Kamar N, Izopet J, Dalton HR (2013). "Chronic hepatitis e virus infection and treatment". Journal of Clinical and Experimental Hepatology. 3 (2): 134–140. doi:10.1016/j.jceh.2013.05.003. ISSN 0973-6883. PMC 3940092. PMID 25755487.
  14. ^ Kamar N, Abravanel F, Selves J, Garrouste C, Esposito L, Lavayssière L, et al. (2010). "Influence of Immunosuppressive Therapy on the Natural History of Genotype 3 Hepatitis-E Virus Infection After Organ Transplantation". Transplantation. 89 (3): 353–360. doi:10.1097/tp.0b013e3181c4096c. PMID 20145528. S2CID 19917145.
  15. ^ Dalton HR, Kamar N, Baylis SA, Moradpour D, Wedemeyer H, Negro F (June 2018). "EASL Clinical Practice Guidelines on hepatitis E virus infection". Journal of Hepatology. 68 (6): 1256–1271. doi:10.1016/j.jhep.2018.03.005. PMID 29609832.
  16. ^ Sridhar S, Teng JL, Chiu TH, Lau SK, Woo PC (20 April 2017). "Hepatitis E Virus Genotypes and Evolution: Emergence of Camel Hepatitis E Variants". International Journal of Molecular Sciences. 18 (4): 869. doi:10.3390/ijms18040869. ISSN 1422-0067. PMC 5412450. PMID 28425927.
  17. ^ a b Izopet J, Abravanel F, Dalton HR, Kamar N (1 January 2014). "Hepatitis E Virus Infection". Clinical Microbiology Reviews. 27 (1): 116–138. doi:10.1128/CMR.00057-13. ISSN 0893-8512. PMC 3910910. PMID 24396139.
  18. ^ Li SW, Zhao Q, Wu T, Chen S, Zhang J, Xia NS (25 February 2015). "The development of a recombinant hepatitis E vaccine HEV 239". Human Vaccines & Immunotherapeutics. 11 (4): 908–914. doi:10.1080/21645515.2015.1008870. ISSN 2164-5515. PMC 4514148. PMID 25714510.
  19. ^ Kumar S, Subhadra S, Singh B, Panda B (April 2013). "Hepatitis E virus: the current scenario". International Journal of Infectious Diseases. 17 (4): e228 – e233. doi:10.1016/j.ijid.2012.11.026. ISSN 1201-9712. PMID 23313154.
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