Hepatitis E virus infections in Europe

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis E virus (HEV) is the leading cause of acute viral hepatitis globally.
• Zoonotic HEV genotypes (3-8) are prevalent in Europe, transmitted via food, contact, water, or blood products.
• HEV-3 is the most common genotype in Europe, with distinct clade and subgenotype distributions.

Purpose of the Study:

• To analyze the evolving epidemiology and clinical consequences of HEV infection in Europe.
• To highlight the impact of improved diagnostic and genotyping tools on understanding HEV.
• To discuss the variations in HEV monitoring systems and the need for enhanced prevention strategies.

Main Methods:

• Systematic review of diagnostic and genotyping tools for HEV.
• Analysis of epidemiological data on HEV prevalence, incidence, and transmission routes in Europe.
• Evaluation of clinical outcomes, including asymptomatic infections, severe hepatitis, and extra-hepatic manifestations.

Main Results:

• HEV infections in Europe primarily stem from zoonotic sources (pigs, wild boar, deer, rabbits).
• HEV-3 infections, though often asymptomatic, can cause severe hepatitis and extra-hepatic issues, particularly in vulnerable populations.
• HEV monitoring systems vary across Europe, likely leading to underestimation of severe cases, hospitalizations, and deaths.

Conclusions:

• Understanding HEV epidemiology requires advanced diagnostic and genotyping tools.
• Variations in HEV seroprevalence and incidence are influenced by environmental factors and food chain contamination.
• Collaborative initiatives like the HEVnet database are crucial for effective HEV prevention in Europe.