Hepatitis E

Written by Ashish Chandra Shrestha

Hepatitis E virus (HEV), also referred to as enterically transmitted non-A non-B hepatitis virus, has been associated with waterborne outbreaks since 1955. Availability of serological tests for hepatitis A and hepatitis B virus, identified this virus as a different causative agent of acute hepatitis. HEV is endemic in developing countries and associated with poor sanitation and water borne outbreaks. However, in developed countries, traditionally HEV was associated with travelers returning from HEV endemic countries. Zoonotic or food borne transmission has contributed to increase in number of locally acquired cases in developed nations. The epidemiology, pathogenicity and mode of transmission varies with infecting genotype of this virus.

Clinical Features

Pathogenesis

Comorbidities

Cellular Characteristics

Genetics

Treatment

Epidemiology

References

  1. "Viswanathan R. Epidemiology. Indian J Med Res. 1957;45(Suppl.):1-29. 1957/01/01"
  2. "Ramalingaswami V, Purcell R. Waterborne non-A non-B hepatitis. The Lancet. 1988;331(8585):571-3."
  3. "Arankalle VA, Ticehurst J, Sreenivasan MA, Kapikian AZ, Popper H, Pavri KM, Purcell RH. Aetiological association of a virus-like particle with enterically transmitted non-A, non-B hepatitis. The Lancet. 1988;331(8585):550-4."
  4. "Wong D, Purcell R, Mandyam Ammanjee S, Rama Prasad S, Pavri K. Epidemic and endemic hepatitis in India: Evidence for a non-A, non-B hepatitis virus aetiology. The Lancet. 1980;316(8200):876-9."
  5. "Aggarwal R. The Global Prevalence of Hepatitis E Virus Infection and Susceptibility: A systematic Review: World Health Organization; 2010 [Available from: http://whqlibdoc.who.int/hq/2010/WHO_IVB_10.14_eng.pdf."
  6. "Dalton HR, Webb GW, Norton BC, Woolson KL. Hepatitis E Virus: Time to Change the Textbooks. Dig Dis. 2016;34(4):308-16."
  7. "Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008;8(11):698-709."
  8. "Scobie L, Dalton HR. Hepatitis E: source and route of infection, clinical manifestations and new developments. J Viral Hepat. 2013;20(1):1-11."
  9. "Meng X, Anderson D, Arankalle V, Emerson S, Harrison T, Jameel S, Okamoto H. Hepeviridae. Virus Taxonomy, 9th Report of the ICTV Elsevier Academic Press, London. 2012:1021-8."
  10. "Perez-Gracia MT, Suay B, Mateos-Lindemann ML. Hepatitis E: an emerging disease. Infect Genet Evol. 2014;22:40-59."
  11. "Brown EA, Ticehurst J, Lemon SM. Immunopathology of Hepatitis A and Hepatitis E Virus Infections. In: Thomas HC, Waters J, editors. Immunology of Liver Disease. Dordrecht: Springer Netherlands; 1994. p. 11-37."
  12. "Shrestha AC, Faddy HM, Flower RL, Seed CR, Keller AJ. Hepatitis E virus: do locally acquired infections in Australia necessitate laboratory testing in acute hepatitis patients with no overseas travel history? Pathology. 2015;47(2):97-100."
  13. "
  14. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27(1):116-38."
  15. "Shinde NR, Patil TB, Deshpande AS, Gulhane RV, Patil MB, Bansod YV. Clinical Profile, Maternal and Fetal Outcomes of Acute Hepatitis E in Pregnancy. Annals of Medical and Health Sciences Research. 2014;4(Suppl 2):S133-S9."
  16. "Kuo VC. Hepatitis E infection. Proc (Bayl Univ Med Cent). 2012;25(2):119-20."
  17. "Kamar N, Bendall R, Legrand-Abravanel F, Xia N-S, Ijaz S, Izopet J, Dalton HR. Hepatitis E. The Lancet. 2012;379(9835):2477-88."
  18. "Haagsma EB, van den Berg AP, Porte RJ, Benne CA, Vennema H, Reimerink JH, Koopmans MP. Chronic hepatitis E virus infection in liver transplant recipients. Liver Transpl. 2008;14(4):547-53."
  19. "Abravanel F, Lhomme S, Chapuy-Regaud S, Mansuy J-M, Muscari F, Sallusto F, Rostaing L, Kamar N, Izopet J. Hepatitis E Virus Reinfections in Solid-Organ-Transplant Recipients Can Evolve Into Chronic Infections. J Infect Dis. 2014;209(12):1900-6."
  20. "Dalton HR, Bendall RP, Keane FE, Tedder RS, Ijaz S. Persistent Carriage of Hepatitis E Virus in Patients with HIV Infection. N Engl J Med. 2009;361(10):1025-7."
  21. "He S, Miao J, Zheng Z, Wu T, Xie M, Tang M, Zhang J, Ng MH, Xia N. Putative receptor-binding sites of hepatitis E virus. J Gen Virol. 2008;89(Pt 1):245-9."
  22. "Longer CF, Denny SL, Caudill JD, Miele TA, Asher LVS, Myint KSA, Huang C-C, Engler WF, LeDuc JW, Binn LN, Ticehurst JR. Experimental Hepatitis E: Pathogenesis in Cynomolgus Macaques (Macaca fascicularis). J Infect Dis. 1993;168(3):602-9."
  23. "Sultan Khuroo M, Kamili S, Yousuf Dar M, Moecklii R, Jameel S. Hepatitis E and long-term antibody status. The Lancet. 1993;341(8856):1355."
  24. "Drebber U, Odenthal M, Aberle SW, Winkel N, Wedemeyer I, Hemberger J, Holzmann H, Dienes HP. Hepatitis E in liver biopsies from patients with acute hepatitis of clinically unexplained origin. Front Physiol. 2013;4:351."
  25. "Agrawal V, Goel A, Rawat A, Naik S, Aggarwal R. Histological and immunohistochemical features in fatal acute fulminant hepatitis E. Indian J Pathol Microbiol. 2012;55(1):22-7."
  26. "Feagins AR, Opriessnig T, Guenette DK, Halbur PG, Meng XJ. Detection and characterization of infectious Hepatitis E virus from commercial pig livers sold in local grocery stores in the USA. J Gen Virol. 2007;88(Pt 3):912-7."
  27. "Wenzel JJ, Preiss J, Schemmerer M, Huber B, Plentz A, Jilg W. Detection of hepatitis E virus (HEV) from porcine livers in Southeastern Germany and high sequence homology to human HEV isolates. J Clin Virol. 2011;52(1):50-4."
  28. "Wilhelm BJ, Rajic A, Greig J, Waddell L, Trottier G, Houde A, Harris J, Borden LN, Price C. A systematic review/meta-analysis of primary research investigating swine, pork or pork products as a source of zoonotic hepatitis E virus. Epidemiol Infect. 2011;139(8):1127-44."
  29. "Shrestha AC, Flower RL, Seed CR, Keller AJ, Harley R, Chan HT, Hoad V, Warrilow D, Northill J, Holmberg JA, Faddy HM. Hepatitis E virus RNA in Australian blood donations. Transfusion. 2016;56(12):3086-93. 2016/10/21"
  30. "Kumar A, Beniwal M, Kar P, Sharma JB, Murthy NS. Hepatitis E in pregnancy. Int J Gynecol Obstet. 2004;85(3):240-4."
  31. "Kumar RM, Uduman S, Rana S, Kochiyil JK, Usmani A, Thomas L. Sero-prevalence and motherto-infant transmission of hepatitis E virus among pregnant women in the United Arab Emirates. Eur J Obstet Gynecol Reprod Biol. 2001;100(1):9-15."
  32. "Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology. 2012;55(4):988-97."
  33. "Shrestha AC, Seed CR, Flower RL, Rooks KM, Keller AJ, Harley RJ, Chan HT, Holmberg JA, Faddy HM. Hepatitis E virus and implications for blood supply safety, Australia. Emerg Infect Dis. 2014;20(11):1940-2."
  34. "Tsarev SA, Tsareva TS, Emerson SU, Govindarajan S, Shapiro M, Gerin JL, Purcell RH. Recombinant vaccine against hepatitis E: dose response and protection against heterologous challenge. Vaccine. 1997;15(17–18):1834-8."
  35. "Shrestha MP, Scott RM, Joshi DM, Mammen MP, Thapa GB, Thapa N, Myint KSA, Fourneau M, Kuschner RA, Shrestha SK, David MP, Seriwatana J, Vaughn DW, Safary A, Endy TP, Innis BL. Safety and Efficacy of a Recombinant Hepatitis E Vaccine. N Engl J Med. 2007;356(9):895-903."
  36. "Li SW, Zhang J, Li YM, Ou SH, Huang GY, He ZQ, Ge SX, Xian YL, Pang SQ, Ng MH, Xia NS. A bacterially expressed particulate hepatitis E vaccine: antigenicity, immunogenicity and protectivity on primates. Vaccine. 2005;23(22):2893-901."
  37. "Zhang J, Liu C-b, Li R-c, Li Y-m, Zheng Y-j, Li Y-p, Luo D, Pan B-b, Nong Y, Ge S-X, Xiong J-h, Shih JW-k, Ng M-H, Xia N-s. Randomized-controlled phase II clinical trial of a bacterially expressed recombinant hepatitis E vaccine. Vaccine. 2009;27(12):1869-74."
  38. "Zhu F-C, Zhang J, Zhang X-F, Zhou C, Wang Z-Z, Huang S-J, Wang H, Yang C-L, Jiang H-M, Cai JP, Wang Y-J, Ai X, Hu Y-M, Tang Q, Yao X, Yan Q, Xian Y-L, Wu T, Li Y-M, Miao J, Ng M-H, Shih JW-K, Xia N-S. Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large-scale, randomised, double-blind placebo-controlled, phase 3 trial. The Lancet.376(9744):895-902."
  39. "Dalton HR, Kamar N. Treatment of hepatitis E virus. Curr Opin Infect Dis. 2016;29(6):639-44."
  40. "Peron JM, Dalton H, Izopet J, Kamar N. Acute autochthonous hepatitis E in western patients with underlying chronic liver disease: a role for ribavirin? J Hepatol. 2011;54(6):1323-5."
  41. "Kamar N, Rostaing L, Abravanel F, Garrouste C, Esposito L, Cardeau-Desangles I, Mansuy JM, Selves J, Peron JM, Otal P, Muscari F, Izopet J. Pegylated interferon-alpha for treating chronic hepatitis E virus infection after liver transplantation. Clin Infect Dis. 2010;50(5):e30-3."
  42. "Aggarwal R. Diagnosis of hepatitis E. Nat Rev Gastroenterol Hepatol. 2013;10(1):24-33."
  43. "Sauleda S, Ong E, Bes M, Janssen A, Cory R, Babizki M, Shin T, Lindquist A, Hoang A, Vang L, Piron M, Casamitjana N, Koppelman M, Danzig L, Linnen JM. Seroprevalence of hepatitis E virus (HEV) and detection of HEV RNA with a transcription-mediated amplification assay in blood donors from Catalonia (Spain). Transfusion. 2015;55(5):972-9. 2014/11/19"