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Hepatitis E: a largely underestimated, emerging threat.

S J Wallace1, C Crossan2, S H Hussaini3

  • 1Speciality Registrar, Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN.

British Journal of Hospital Medicine (London, England : 2005)
|July 9, 2019
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Hepatitis E virus (HEV) genotypes 3 and 4 are common causes of liver disease in high-income nations, posing risks to immunocompromised individuals. This review covers HEV epidemiology, clinical issues, and prevention strategies for this public health concern.

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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.