Hepatitis E Virus in Industrialized Countries: The Silent Threat

Abstract

Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide. Its presence in developing countries has been documented for decades. Developed countries were supposed to be virus-free and initially only imported cases were detected in those areas. However, sporadic and autochthonous cases of HEV infection have been identified and studies reveal that the virus is worldwide spread. Chronic hepatitis and multiple extrahepatic manifestations have also been associated with HEV. We review the data from European countries, where human, animal, and environmental data have been collected since the 90s. In Europe, autochthonous HEV strains were first detected in the late 90s and early 2000s. Since then, serological data have shown that the virus infects quite frequently the European population and that some species, such as pigs, wild boars, and deer, are reservoirs. HEV strains can be isolated from environmental samples and reach the food chain, as shown by the detection of the virus in mussels and in contaminated pork products as sausages or meat. All these data highlight the need of studies directed to control the sources of HEV to protect immunocompromised individuals that seem the weakest link of the HEV epidemiology in industrialized regions.

Hepatitis E seroprevalence in the United States: Results for immunoglobulins IGG and IGM

“…HEV displays a wide range of clinical presentations, from acute liver failure to asymptomatic subclinical unrecognized infection. HEV is a persistent “silent threat” in developed nations …”

“…HEV is a persistent "silent threat" in developed nations. 7 Most HEV infection is asymptomatic in developed regions.…”

Seroepidemiology of hepatitis E virus infection in pigs in Durango State, Mexico

“…Hepatitis E virus (HEV) is a small, nonenveloped virus with a single stranded RNA genome . Infection with HEV occurs widely around the world . HEV is the main cause of acute viral hepatitis worldwide .…”

“…1 Infection with HEV occurs widely around the world. 2 HEV is the main cause of acute viral hepatitis worldwide. 2 Infection with HEV may lead to chronic hepatitis and, in transplant recipients, to liver cirrhosis and organ failure.…”

“…2 HEV is the main cause of acute viral hepatitis worldwide. 2 Infection with HEV may lead to chronic hepatitis and, in transplant recipients, to liver cirrhosis and organ failure. 3 Acute hepatitis E has the highest attack rate in young adults, and the disease is more severe in pregnant women.…”