Extrahepatic manifestations of hepatitis E virus: An overview

Fousekis, Fotios S.; Mitselos, Ioannis V; Christodoulou, Dimitrios

doi:10.3350/cmh.2019.0082

Cited by 51 publications

(55 citation statements)

References 83 publications

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“…Hepatitis E infection has been associated with a wide spectrum of extra-hepatic, mainly neurological, renal, cardiac, and hematological manifestations ( Fousekis et al, 2020 ; Figure 4 ). HEV also has been detected in the human placenta, breast milk, and urine ( Pischke et al, 2017 ; Rivero-Juarez et al, 2019 ).…”

Section: Hev Chronicity and Extrahepatic Manifestationsmentioning

confidence: 99%

Viral Hepatitis E and Chronicity: A Growing Public Health Concern

et al. 2020

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Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, the understanding of hepatitis E virus (HEV) had changed with the discovery of new genotypes like genotype-7 and genotype-8 with associated host and mode of infection. Diversification in the mode of hepatitis E infection transmission through blood transfusion, and organ transplants in contrast to classical feco-oral and zoonotic mode is the recent medical concern. The wide spectrum of infection ranging from self-limiting to acute liver failure is now overpowered by HEV genotype-specific chronic infection especially in transplant patients. This concern is further escalated by the extra-hepatic manifestations of HEV targeting the central nervous system (CNS), kidney, heart, and pancreas. However, with the development of advanced efficient cell culture systems and animal models simulating the infection, much clarity toward understanding the pathogenetic mechanism of HEV has been developed. Also this facilitates the development of vaccines research or therapeutics. In this review, we highlight all the novel findings in every aspect of HEV with special emphasis on recently emerging chronic mode of infection with specific diagnosis and treatment regime with an optimistic hope to help virologists and/or liver specialists working in the field of viral hepatitis.

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Section: Hev Chronicity and Extrahepatic Manifestationsmentioning

confidence: 99%

Viral Hepatitis E and Chronicity: A Growing Public Health Concern

et al. 2020

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“…The structure of the HEV genome was thoroughly studied in 1991. The RNA molecule consists of 7200 positively directed nucleotides [ 6 ]. There are three main coding regions whose protein products have not been thoroughly studied.…”

Section: Introductionmentioning

confidence: 99%

“…There are three main coding regions whose protein products have not been thoroughly studied. It was also found that there is a fourth coding region characteristic of the HEV-1 genotype [ 6 , 7 , 8 ]. The heparan sulfate proteoglycan, HSC70 (heat shock cognate 70 kDa), allows HEV to enter the cell.…”

Section: Introductionmentioning

confidence: 99%

Towards the Improved Accuracy of Hepatitis E Diagnosis in Vulnerable and Target Groups: A Global Perspective on the Current State of Knowledge and the Implications for Practice

et al. 2021

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The hepatitis E virus (HEV) is a positive single-stranded, icosahedral, quasi-enveloped RNA virus in the genus Orthohepevirus of the family Hepeviridae. Orthohepevirus A is the most numerous species of the genus Orthohepevirus and consists of eight different HEV genotypes that can cause infection in humans. HEV is a pathogen transmitted via the fecal–oral route, most commonly by consuming fecally contaminated water. A particular danger is the HEV-1 genotype, which poses a very high risk of vertical transmission from the mother to the fetus. Several outbreaks caused by this genotype have been reported, resulting in many premature births, abortions, and also neonatal and maternal deaths. Genotype 3 is more prevalent in Europe; however, due to the openness of the market, i.e., trade-in animals which represent a natural reservoir of HEV (such as pigs), there is a possibility of spreading HEV infections outside endemic areas. This problem is indeed global and requires increased hygiene measures in endemic areas, which entails special care for pregnant women in both endemic and non-endemic regions. As already highlighted, pregnant women could have significant health consequences due to the untimely diagnosis of HEV infection; hence, this is a population that should be targeted with a specific combination of testing approaches to ensure optimal specificity and sensitivity. Until we advance from predominantly supportive treatment in pregnancy and appraise the safety and efficacy of a HEV vaccine in this population, such screening approaches represent the mainstay of our public health endeavors.

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“…Hemolytic anemia occurs in 23% of victims as the intricacy of acute hepatitis. Nevertheless, the occurrence can ascend to 70% in patients harboring G6PD insufficiency [ 3 ]. Fulminant hepatic failure includes proof of coagulation variation from the norm, generally an international normalized ratio (INR)≥1.5, and any level of mental transformation in a patient without prior cirrhosis and with a sickness of <26 weeks [ 4 ].…”

Section: Introductionmentioning

confidence: 99%