Hepatitis E: a largely underestimated, emerging threat.

Area of Science:

• Hepatology and Virology
• Infectious Diseases Epidemiology

Background:

• Hepatitis E virus (HEV) exhibits distinct genotypes with varying clinical and epidemiological patterns.
• Genotypes 3 and 4 are prevalent in high-income countries, representing a growing concern for viral hepatitis.
• HEV infections are associated with significant morbidity and mortality, particularly in immunocompromised patients and those with pre-existing liver conditions.

Purpose of the Study:

• To review the current understanding of Hepatitis E virus epidemiology, virology, and clinical presentations.
• To identify patient groups at high risk for severe HEV infection.
• To provide guidance on the diagnosis, treatment, and prevention of Hepatitis E.

Main Methods:

• Literature review of current research on Hepatitis E virus.
• Analysis of epidemiological data on HEV genotypes 3 and 4.
• Synthesis of clinical information regarding HEV manifestations and extra-hepatic associations.

Main Results:

• HEV genotypes 3 and 4 are the most common causes of viral hepatitis in Europe and high-income countries.
• HEV infections lead to substantial illness and death in vulnerable populations, including those with compromised immunity or liver disease.
• Emerging evidence highlights extra-hepatic manifestations, such as neurological and kidney injuries, challenging the 'hepatitis' classification.

Conclusions:

• Hepatitis E is an increasing public health hazard, especially genotypes 3 and 4 in developed nations.
• Immunosuppressed individuals and those with liver disease are at significant risk.
• Comprehensive strategies for diagnosis, treatment, and prevention are crucial to manage this growing threat.