Hepatitis E Virus Infection: Circulation, Molecular Epidemiology, and Impact on Global Health

Abstract

Infection with hepatitis E virus (HEV) represents the most common source of viral hepatitis globally. Although infecting over 20 million people annually in endemic regions, with major outbreaks described since the 1950s, hepatitis E remains an underestimated disease. This review gives a current view of the global circulation and epidemiology of this emerging virus. The history of HEV, from the first reported enteric non-A non-B hepatitis outbreaks, to the discovery of the viral agent and the molecular characterization of the different human pathogenic genotypes, is discussed. Furthermore, the current state of research regarding the virology of HEV is critically assessed, and the challenges towards prevention and diagnosis, as well as clinical risks of the disease described. Together, these points aim to underline the significant impact of hepatitis E on global health and the need for further in-depth research to better understand the pathophysiology and its role in the complex disease manifestations of HEV infection.

Keywords: epidemiology; global health; hepatitis E; infection; outbreak.

Figure 1

Genome arrangement of hepatitis E virus (HEV) and steps of viral genome replication.

Figure 2

Global HEV genotype distribution. Different colors on the map indicate the distribution of HEV genotypes (HEV-1 through -4) across the globe. The figure was created using SimpleMappr, an online tool to produce publication-quality point maps [149].