Acute Hepatitis E: Two Sides of the Same Coin

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis E virus (HEV) infections were historically underestimated and misperceived as tropical diseases.
• Autochthonous HEV infections, particularly genotype 3, are increasingly recognized in industrialized nations.

Purpose of the Study:

• To highlight the rising incidence and significance of HEV infections in Western countries.
• To discuss transmission routes, clinical manifestations, and at-risk populations for HEV.
• To review current treatment approaches for HEV infections.

Main Methods:

• Review of epidemiological data on autochthonous HEV infections.
• Analysis of transmission sources, including swine meat and contaminated water.
• Description of clinical presentations and outcomes in different patient groups.

Main Results:

• HEV genotype 3 is the predominant cause of autochthonous infections in industrialized countries, often linked to swine meat consumption.
• Most healthy individuals experience asymptomatic or mild HEV infections.
• HEV can lead to severe liver complications, including acute liver failure (especially in pregnant women) and chronic hepatitis E in immunosuppressed individuals.

Conclusions:

• HEV is a significant public health concern in Western countries, requiring increased awareness and diagnostic efforts.
• Specific treatment for HEV is lacking, but off-label ribavirin shows promise for chronic infections and acute liver failure.
• Further research into HEV pathogenesis, prevention, and treatment is warranted.