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Hepatitis E virus: Infection beyond the liver?

Sven Pischke1, Johannes Hartl1, Suzan D Pas2

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Hepatitis E virus (HEV) infections can affect organs beyond the liver, causing various neurological and renal conditions. Further research is needed to confirm HEV

Keywords:
Antiviral agentsExtrahepatic manifestationsHEVHepatitis ERibavirin

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Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Hepatitis E virus (HEV) infections are recognized to extend beyond hepatic manifestations.
  • A range of extrahepatic diseases have been associated with HEV, including neurological, renal, and autoimmune conditions.

Purpose of the Study:

  • To comprehensively review the literature on Hepatitis E virus and its extrahepatic manifestations.
  • To discuss the probability of HEV causing specific extrahepatic diseases and summarize treatment knowledge.

Main Methods:

  • Review of published literature on HEV and extrahepatic manifestations.
  • Analysis of serological studies, case series, in vitro data, and animal models.
  • Discussion of potential pathophysiological mechanisms and treatment efficacy.

Main Results:

  • HEV infection is strongly suggested to cause neuronal and renal diseases, and pancreatitis.
  • The causative link between HEV and other observed extrahepatic diseases remains less certain.
  • Potential mechanisms include direct viral cytopathic effects or immune-mediated damage.

Conclusions:

  • Hepatologists and other specialists should consider HEV as a differential diagnosis for specific extrahepatic manifestations.
  • Antiviral treatments like ribavirin and steroids show potential but require validation through large-scale studies.
  • Establishing definitive pathophysiological links and treatment protocols for HEV-associated extrahepatic disorders is crucial.