Hepatitis E: Discovery, global impact, control and cure

Abstract

Hepatitis E was identified as an epidemic of non-A, non-B hepatitis from Kashmir, India in 1978. Hepatitis E virus (HEV), the etiological agent is the sole member of family Hepeviridae. The virus has marked heterogeneity and infects many animals like bats, camel, chicken, deer, boar, mongoose, pigs, rats, rabbit and cutthroat trout. Hepatitis E is a disease with a major global impact and has two distinct epidemiological patterns. Hepatitis E is an imperative health issue in developing nations, transmitted through sullied water and happens most every now in young adults. The disease is particularly severe during pregnancy and in people with underlying liver cirrhosis. Autochthonous hepatitis E is increasingly recognized in developed countries. The virus infects domestic pigs, wild boar and Sika deer in these countries. HEV infections in humans occur by eating the undercooked game flesh, raw liver from supermarkets and Figatelli sausages. Blood transfusion-associated HEV infections occur in many countries and screening of donors for HEV RNA is under consideration. Hepatitis E causes a number of extrahepatic diseases, including a wide spectrum of neurological syndromes. HEV genotype 3 causes prolonged viremia, chronic hepatitis, liver fibrosis and cirrhosis in organ transplant patients. The virus is amenable to ribavirin monotherapy and most patients clear the virus in a few weeks. Hepatitis E vaccine -239, marketed in China, has shown high efficacy with sustained protection for over four years.

Hepatitis E virus replication and interferon responses in human placental cells

“…Viruses of gt1 and gt2 are found mainly in developing countries and are transmitted by the fecal–oral route. They solely infect humans and show high epidemic potential, causing up to 120,000 symptomatic cases in a single outbreak 4. Viruses of gt3 and gt4 cause zoonotic infections transmitted mainly by contaminated food or transfusion of contaminated blood products 5.…”

Phage-displayed peptides that mimic epitopes of hepatitis E virus capsid

“…PepSurf algorithm was used to map affinity-selected peptides onto the ORF2 crystal structure of HEV genotype 3, which predicted that these four mimototopes are clustered in the P domain of ORF2 capsid, near conformational epitopes of anti-HEV neutralising monoclonal antibodies. These HEV mimotopes may have HEV usually causes a self-limiting infection in immunocompetent individuals but HEV genotype 3 can cause chronic hepatitis in immunocompromised such as transplant recipients [13]. Increasing number of reports points also at potential extrahepatic complications such as neurological symptoms [14].…”

Challenges in research and management of hepatitis E virus infection in Cuba, Mexico, and Uruguay

“…HEV-G1 is hyperendemic in Asia and Africa and frequently causes large outbreaks of acute hepatitis (7). This genotype has also been detected in Cuba, Uruguay, and Venezuela (3)(4).…”

“…HEV-G4 is almost exclusively restricted to Asia (3,4,7). HEV genotypes and reservoirs from nine LAC countries (Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico, Uruguay, Venezuela) (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) are shown in Table 1.…”

“…HEV genotypes and reservoirs from nine LAC countries (Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico, Uruguay, Venezuela) (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) are shown in Table 1. Specific clinical manifestations of HEV infection have been tentatively associated with distinct genotypes; for example, HEV-G1 is related to fulminant acute hepatitis in pregnancy, whereas HEV-G3 is associated with chronic liver disease in immunosuppressed patients (2,7).…”