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[How to investigate and diagnose autochthonous hepatitis E?]
C Renou1, E Nicand, A Pariente
1Hôpital de Jour, centre hospitalier de Hyères, rue du Maréchal-Juin, Hyères, France. crenou@ch-hyeres.fr
Gastroenterologie Clinique Et Biologique
|September 19, 2009
Summary
Hepatitis E virus (HEV) is now a common, autochthonous infection in developed countries, posing a higher mortality risk, especially for the elderly. Pregnant women and immunocompromised individuals face unique risks from this evolving public health concern.
Area of Science:
- * Virology and Epidemiology
- * Infectious Diseases
- * Public Health
Background:
- * Hepatitis E virus (HEV) was historically considered rare and imported into developed countries.
- * Recent evidence indicates HEV is now an autochthonous (locally acquired) disease in these regions.
Observation:
- * Transmission routes, including food-borne (zoonotic) and blood-borne, are increasingly identified.
- * HEV infection shows higher mortality rates in industrialized nations compared to endemic areas.
- * Elderly individuals with chronic liver disease exhibit a significantly elevated mortality risk (approaching 70%).
Findings:
- * Unlike developing countries where pregnancy increases HEV mortality, no deaths in pregnant women from autochthonous HEV cases have been reported in developed countries.
- * HEV infection can lead to chronic hepatitis in immunocompromised patients, particularly solid organ transplant recipients.
- * Chronic HEV infection in immunocompromised individuals may progress to cirrhosis.
Implications:
- * Public health strategies need to address the growing burden of autochthonous HEV in developed countries.
- * Increased awareness and diagnostic vigilance are crucial for identifying HEV in at-risk populations.
- * Further research into transmission, prevention, and management of HEV, especially in vulnerable groups, is warranted.
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