Neutralizing antibodies as A therapy for hepatitis E virus: Advances, challenges and opportunities

Hepatitis E virus (HEV) infection is a leading cause for acute hepatitis worldwide posing a significant public health threat but no FDA-approved therapy is currently available. Studies have shown that HEV-specific antibodies are protective against HEV infection both in vitro and in vivo; therefore, antibodies may be considered a potential therapy for high-risk populations (e.g., pregnant women and immunocompromised individuals). Many potent neutralizing monoclonal antibodies (mAbs) against HEV have been identified and characterized, showing great promise for therapeutic development. Here we provide a summary of neutralizing antibodies against HEV described to date, focusing on the epitopes they recognize and the mechanisms of neutralization for selected mAbs. Since HEV has unique antibody evasion mechanisms potentially reducing the effectiveness of therapeutic antibodies, we offer perspectives on how to overcome these obstacles.