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[Hepatitis E: Epidemiology, pathology and prevention].

Nancy León-Janampa1, Denys Brand1, Julien Marlet1

  • 1INSERM U1259 MAVIVHe, Université de Tours et CHRU de Tours, Tours, France.

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Hepatitis E virus (HEV) causes acute hepatitis, with specific genotypes linked to epidemics and zoonotic transmission. While often resolving spontaneously, HEV can lead to chronic infection in immunocompromised individuals, highlighting the need for hygiene and safe water.

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Area of Science:

  • Hepatology and Virology
  • Infectious Diseases Epidemiology
  • Public Health and Preventive Medicine

Background:

  • Hepatitis E virus (HEV) is a significant global pathogen responsible for acute hepatitis.
  • Distinct HEV genotypes exhibit varied transmission routes and clinical manifestations.
  • Genotypes 1 and 2 are linked to waterborne outbreaks and severe hepatitis in pregnant women.

Purpose of the Study:

  • To provide a comprehensive overview of Hepatitis E virus epidemiology and clinical significance.
  • To discuss transmission dynamics, including oro-faecal routes and zoonotic potential.
  • To highlight prevention strategies and the status of vaccine development.

Main Methods:

  • Review of existing literature on Hepatitis E virus.
  • Analysis of epidemiological data concerning HEV genotypes and their distribution.
  • Summary of clinical presentations, including acute, chronic, and extrahepatic manifestations.

Main Results:

  • HEV genotypes 1 and 2 cause epidemics via oro-faecal transmission and severe hepatitis.
  • HEV genotypes 3 and 4 represent a zoonosis transmitted through consumption of undercooked pork.
  • Most infections are self-limiting, but chronic hepatitis can develop in immunocompromised patients.

Conclusions:

  • Effective prevention relies on improved hygiene and access to safe drinking water.
  • Extrahepatic manifestations of HEV infection are possible and require clinical consideration.
  • A recombinant HEV vaccine has been developed and is undergoing WHO validation.