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Review
. 2021 Aug 30;5(10):1127-1134.
doi: 10.1002/jgh3.12646. eCollection 2021 Oct.

Hepatitis E: Genotypes, strategies to prevent and manage, and the existing knowledge gaps

Lubna Kamani  1   2 , Zahra Ali Padhani  3 , Jai K Das  4
Affiliations
Review

Hepatitis E: Genotypes, strategies to prevent and manage, and the existing knowledge gaps

Lubna Kamani et al. JGH Open. .

Abstract

Hepatitis E virus (HEV) is considered an emergent source of viral hepatitis worldwide, with an increasing burden of jaundice, liver failure, extrahepatic illnesses, and deaths in developed countries. With the scarcity of data from efficient animal models, there are still open-ended questions about designing new models to study pathogenesis, types, virology, and evolution of these viruses. With an emphasis on available data and updates, there is still enough information to understand the HEV life cycle, pathogen interaction with the host, and the valuation of the role of vaccine and new anti-HEV therapies. However, the World Health Organization (WHO) and the European Association for the Study of the Liver (EASL) preferred to stress prevention and control measures of HEV infections in animals, zoonotic transmission, and foodborne transmission. It is being reviewed that with current knowledge on HEV and existing prevention tools, there is an excellent room for in-depth information about the virus strains, their replication, pathogenicity, and virulence. The current knowledge set also has gaps regarding standardized and validated diagnostic tools, efficacy and safety of the vaccine, and extrahepatic manifestations specifically in pregnant females, immunocompromised patients, and others. This review highlights the areas for more research exploration, focusing on enlisted research questions based on HEV infection to endorse the need for significant improvement in the current set of knowledge for this public health problem.

Keywords: acute hepatitis; hepatitis E virus; hepatitis E virus treatment; hepatitis E virus vaccine; viral Hepatitis.

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Figures

Figure 1
Figure 1
Genomic organization of HEV showing e positive sense HEV genomic RNA and a subgenomic RNA produced during replication of three ORFs, which encode ORF1, ORF2, and ORF3 proteins. The scale below shows nucleotides in thousands (Adapted from Hoofnagle et al., Chandra et al., Wedemeyer et al. and Yamashita et al.31).
Figure 2
Figure 2
Diagnostic algorithm for HEV infection (Adapted from European Association for the Study of the Liver.61)
Figure 3
Figure 3
Treatment algorithm for chronic HEV infection (Adapted from European Association for the Study of the Liver.61)
See this image and copyright information in PMC

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