The Re-Emergence of Hepatitis E Virus in Europe and Vaccine Development

Abstract

Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. Transmission of HEV mainly occurs via the fecal-oral route (ingesting contaminated water or food) or by contact with infected animals and their raw meat products. Some animals, such as pigs, wild boars, sheep, goats, rabbits, camels, rats, etc., are natural reservoirs of HEV, which places people in close contact with them at increased risk of HEV disease. Although hepatitis E is a self-limiting infection, it could also lead to severe illness, particularly among pregnant women, or chronic infection in immunocompromised people. A growing number of studies point out that HEV can be classified as a re-emerging virus in developed countries. Preventative efforts are needed to reduce the incidence of acute and chronic hepatitis E in non-endemic and endemic countries. There is a recombinant HEV vaccine, but it is approved for use and commercially available only in China and Pakistan. However, further studies are needed to demonstrate the necessity of applying a preventive vaccine and to create conditions for reducing the spread of HEV. This review emphasizes the hepatitis E virus and its importance for public health in Europe, the methods of virus transmission and treatment, and summarizes the latest studies on HEV vaccine development.

The intersection of virus infection and liver disease: A comprehensive review of pathogenesis, diagnosis, and treatment

“…In 2012, the first prophylactic vaccine against HEV exists licensed in China, obtained application permits in Pakistan subsequently. The hepatitis E vaccine is intended for immunization of susceptible individuals aged 16 and older, and is recommended for high‐risk groups infected with HEV (Nimgaonkar et al, 2018; Zahmanova et al, 2023).…”

Hepatitis E Virus (HEV) Infection Among Immunocompromised Individuals: A Brief Narrative Review

“… 6 The genome of the virus was sequenced in 1991. 1 , 4 In the same year, a diagnostic test for its detection was developed. 5 …”

“… 9 These clinical signs usually last 1–6 weeks and are frequently similar to those observed in other liver diseases. 4 In low-income (LI) countries and lower middle-income (LMI) countries, the virus affects especially badly pregnant women (especially those in the second or third trimester) and neonates; case fatality rates (CFR) of 20–30%. 9 , 12 It is not clear why pregnant women are at greater risk as no suitable animal model exists, but it is thought to be related to changes in hormone levels during pregnancy and their effect on the immune system.…”

“…as well as workers who have close contact with HEV-infected animals have been recognized as major risk groups for severe clinical form, chronic infection, or fatal outcome. 4 , 5 , 14 Serological and nucleic acid tests for HEV detection have been developed for both epidemiologic and diagnostic purposes. 4 …”

“… 4 , 5 , 14 Serological and nucleic acid tests for HEV detection have been developed for both epidemiologic and diagnostic purposes. 4 …”