Hepatitis E: Discovery, global impact, control and cure.

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis E virus (HEV) is the sole member of the Hepeviridae family, identified initially in 1978.
• HEV exhibits significant genetic diversity, infecting a wide range of animal reservoirs including bats, pigs, and deer.
• Hepatitis E presents distinct epidemiological patterns, posing a major global health challenge.

Purpose of the Study:

• To provide a comprehensive overview of Hepatitis E epidemiology, transmission, and clinical manifestations.
• To highlight the global impact of HEV, including its prevalence in developing and developed countries.
• To discuss extrahepatic manifestations, treatment options, and vaccine efficacy.

Main Methods:

• Review of epidemiological data on Hepatitis E.
• Analysis of HEV transmission routes, including waterborne and foodborne pathways.
• Examination of clinical outcomes, extrahepatic manifestations, and therapeutic interventions.

Main Results:

• Hepatitis E is a significant health issue in developing nations, primarily waterborne and affecting young adults.
• In developed countries, autochthonous HEV infections are recognized, linked to consumption of undercooked game meat and processed foods.
• HEV can cause severe disease in pregnant women and individuals with cirrhosis, and is associated with neurological syndromes.
• HEV genotype 3 is linked to chronic hepatitis, fibrosis, and cirrhosis in immunocompromised individuals, such as organ transplant recipients.

Conclusions:

• Hepatitis E requires global attention due to its varied transmission routes and severe outcomes, particularly in vulnerable populations.
• Ribavirin monotherapy is effective for treating HEV infections, with most patients achieving viral clearance.
• The Hepatitis E vaccine (HEV-239) demonstrates high efficacy and sustained protection, offering a promising tool for disease prevention.