Hepatitis E: the forgotten virus

Area of Science:

• Infectious Diseases
• Public Health
• Military Medicine

Background:

• Hepatitis E virus (HEV) has historical ties to military operations, first identified during the Soviet occupation of Afghanistan.
• HEV is now endemic in the UK and presents a public health challenge, particularly in military populations and operational zones.
• High prevalence (28.5%) observed in Afghanistan highlights the risk in deployed forces.

Purpose of the Study:

• To review the clinical presentations of Hepatitis E in military personnel.
• To outline current management strategies for Hepatitis E within military contexts.
• To emphasize the importance of prevention and hygiene in high-risk operational areas.

Main Methods:

• This study is a narrative review.
• It synthesizes existing literature on Hepatitis E epidemiology, clinical features, and management.
• Focus is placed on military populations and operational environments.

Main Results:

• Pregnancy significantly increases the risk of fulminant hepatitis and mortality (up to 25%).
• Management is primarily symptomatic, with ribavirin as a consideration for non-pregnant patients with severe cases.
• Maintaining food/water safety and environmental hygiene is critical for disease control.

Conclusions:

• HEV requires consideration in all jaundice cases, especially within military populations.
• Preventive measures, including hygiene and safe water/food, are paramount in endemic and operational areas.
• Risk stratification, particularly for pregnant individuals, is essential for optimal patient outcomes.