Hepatitis E, the neglected one

Abstract

Hepatitis E virus (HEV) infection is a worldwide disease. It is the first cause of acute viral hepatitis in the world with an estimated 20 million cases every year and 56 000 deaths. In developing countries, hepatitis E is a waterborne infection. In these countries, HEV genotypes 1 and 2 cause large outbreaks and affect young subjects with a significant mortality rate in pregnant women and patients with cirrhosis. In the developed countries, HEV genotypes 3 and 4 are responsible for autochthonous, sporadic hepatitis and transmission is zoonotic. HEV can cause neurological disorders and in immunocompromised patients, chronic infections. The progression of acute hepatitis E is most often mild and resolves spontaneously. Diagnostic tools include anti-HEV IgM antibodies in serum and/or viral RNA in the blood or stools by PCR. Ribavirin is used to treat chronic infection. A vaccine has been developed in China. Keywords acute viral hepatitis -chronic hepatitis -hepatitis E virus -neurological symptoms -ribavirin -zoonosisHepatitis E virus (HEV) was discovered by immune electron microscopy in 1983 by Dr. Balayan, who was investigating an outbreak of unexplained hepatitis in Russian soldiers stationed in Afghanistan (1). The hepatitis E genome was sequenced in 1991. The same year, a test was developed for detecting anti-HEV antibodies (2). The purpose of this paper is to review the virology, epidemiology, clinical aspects and treatment of hepatitis E. Background and virology

Prevalence and Molecular Characterization of the Hepatitis E Virus in Retail Pork Products Marketed in Canada

“…It is notable that the number of reported cases for human HEV infection is increasing (Blasco-Perrin et al 2016; Park et al 2016), which might lead to increased genetic variation and emergence of more virulent strains. Therefore, it is important to monitor and understand the molecular characteristics of circulating HEV strains, and strengthen the source attribution between HEV and causative food products using tools such as WGS.…”

Enhanced Replication of Hepatitis E Virus Strain 47832c in an A549-Derived Subclonal Cell Line

“…It causes worldwide an estimated 20 million cases and 56,000 deaths every year [1]. Most of the cases occur in developing countries where the virus is mainly transmitted by fecally contaminated drinking water.…”

The RNA genome of hepatitis E virus robustly triggers an antiviral interferon response

“…It is one of the most common causes of acute viral hepatitis in the world. Although the infection is generally self‐limiting, severe complications and high mortality rates have been reported in special populations, including pregnant women, immunocompromised patients, and patients with preexisting liver disease . HEV outbreaks periodically occur throughout resource‐limited countries, including the large ongoing outbreak in Niger, resulting in a heavy clinical burden with a high mortality rate in pregnant women .…”