Hepatitis E: Historical, contemporary and future perspectives

Aggarwal, Rakesh

doi:10.1111/j.1440-1746.2010.06540.x

Cited by 102 publications

(81 citation statements)

References 95 publications

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“…24 However, two distinct epidemiological and clinical patterns are observed, with differences in the frequency of disease, virus genotypes causing human infection, routes of transmission, affected population groups and disease characteristics (Table 1). 25,26 Each of these patterns is described below. …”

Section: Geographical Distribution and Epidemiological Patternsmentioning

confidence: 99%

“…25,26 In these areas, hepatitis E occurs as distinct outbreaks of acute hepatitis, as well as frequent sporadic cases. Two small outbreaks were also reported in Mexico during 1986-87 27 ; however, no further outbreaks have since been reported from North America.…”

Section: Geographical Distributionmentioning

confidence: 99%

“…25,26 In these areas, large outbreaks of hepatitis E are unheard of and only a few limited food-borne outbreaks have been reported. 57,58 In these areas, sporadic disease due to HEV infection is also rare, forming only a minority of all cases with acute viral hepatitis.…”

Section: Epidemiology In Low-endemicity Regionsmentioning

confidence: 99%

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Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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Section: Geographical Distribution and Epidemiological Patternsmentioning

confidence: 99%

Section: Geographical Distributionmentioning

confidence: 99%

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Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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“…epatitis E virus (HEV) is a small, single-stranded RNA virus that is transmitted principally by the fecal-oral route in developing nations and presumptively via zoonotic transmission or food exposure in developed nations (1,2). Four genotypes have been identified.…”

mentioning

confidence: 99%

An Epidemiologic Investigation of a Case of Acute Hepatitis E

et al. 2015

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Hepatitis E virus (HEV) is considered a zoonotic infection in developed nations. A case of acute hepatitis E in a researcher following a scalpel injury while working on a pig prompted a seroepidemiologic study to identify potential modes of transmission and determine the seroprevalence of HEV among animal handlers at the institute. Sera from personnel (n ‫؍‬ 64) in two animal facilities and age/sex-matched blood donors (n ‫؍‬ 63) as controls were tested for IgG anti-HEV and, if positive, for IgM anti-HEV and HEV RNA. Sera and stool from pigs aged 6 to 12 weeks from the breeding farm and older pigs from animal facilities were tested similarly. The median age of personnel was 36 years, 74% were white, 56% were male, and 74% had direct exposure to pigs. The prevalence of anti-HEV was 3.1% among personnel compared to 3.2% among blood donors; none were positive for IgM anti-HEV or HEV RNA. IgG anti-HEV was detected in sera from 10% of pigs aged 6 to 8 weeks, 80% aged 10 weeks, 100% aged 12 weeks, and 76% aged >12 weeks. HEV RNA was detected in stool but not sera from three 12-week-old pigs. Sequencing revealed HEV genotype 3 with ϳ10% difference between the patient and pig sequences. Parenteral transmission is a potential mode of acute HEV infection. The low and similar seroprevalence of anti-HEV between the at-risk group and age-matched blood donors suggests low transmission risk with universal precautions among animal handlers.H epatitis E virus (HEV) is a small, single-stranded RNA virus that is transmitted principally by the fecal-oral route in developing nations and presumptively via zoonotic transmission or food exposure in developed nations (1, 2). Four genotypes have been identified. Genotypes 1 and 2 are known to infect only humans and are responsible for large waterborne outbreaks. Genotypes 3 and 4, on the other hand, primarily infect other animals, including swine, rats, and rabbits, among others, and have been associated with sporadic cases of acute and chronic infections in humans (2, 3). Most cases of HEV genotype 3, and probably also genotype 4, are anicteric and asymptomatic and resolve spontaneously without long-term sequelae. However, severe cases with jaundice can occur in the elderly, in persons with immunodeficiency, and in persons with preexisting liver disease. In addition, HEV genotype 1 has been associated with high case fatality rates in pregnant women. Recently, cases of chronic HEV infection due to genotype 3 have been reported in immunosuppressed individuals, such as solid-organ transplant recipients, patients on cancer chemotherapy, and those with human immunodeficiency virus infection and AIDS (4-7).A surprisingly high prevalence of HEV infection, 21%, was reported in the U.S. population from an analysis of samples collected during the Third National Health and Nutrition Examination Survey (NHANES III) (8). Testing positive for anti-HEV was related to older age, and minor associations were found with having a pet in the home and consuming liver or other organ meats more than once per m...

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“…Comparable courses of HEV-1 infection were also observed in experimental infections of non-human primates. In such experiments, HEV RNA could be detected in the serum at approximately 10 dpi [37,38,39]. …”

Section: Current Knowledge About the Pathogenmentioning

confidence: 99%