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Review
. 2023 Dec 25;12(5):262-271.
doi: 10.5501/wjv.v12.i5.262.

Hepatitis E infection: A review

Humzah Iqbal  1 , Bilal Fazal Mehmood  1 , Aalam Sohal  2 , Marina Roytman  3
Affiliations
Review

Hepatitis E infection: A review

Humzah Iqbal et al. World J Virol. .

Abstract

Hepatitis E virus (HEV) is a small non-enveloped virus that is transmitted via the fecal-oral route. It is a highly common cause of acute hepatitis, particularly in low to middle income regions of Asia, Africa, and Central America. Most cases are self-limited, and symptomatic patients usually present with acute icteric hepatitis. A subset of patients including pregnant women, older men, those with pre-existing liver disease and immunocompromised patients however, may develop severe disease and hepatic failure. Immunocompromised patients are also at risk for chronic infection, and their immunosuppression should be decreased in order to facilitate viral clearance. HEV can also present with a variety of extra-intestinal manifestations including neurological, renal, hematological, and pancreatic derangements. The gold standard of diagnosis is HEV ribonucleic acid detection via nucleic acid amplification testing. Currently, there are no approved treatments for Hepatitis E, though ribavirin is the most commonly used agent to reduce viral load. Studies assessing the safety and efficacy of other antiviral agents for HEV are currently underway. HEV vaccination has been approved in China, and is currently being investigated in other regions as well. This review article aims to discuss the epidemiology, pathogenesis, presentation, diagnosis, complications, and treatment of Hepatitis E infection.

Keywords: Acute hepatitis; Chronic hepatitis; Hepatitis E; Vaccination; Viral hepatitis.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest associated with any of the authors of this manuscript.

Figures

Figure 1
Figure 1
Naked hepatitis E virus virion structure. HEV: Hepatitis E virus.
Figure 2
Figure 2
Quasi-enveloped hepatitis E virus virion structure. HEV: Hepatitis E virus.
Figure 3
Figure 3
Flowchart of diagnostic testing for acute hepatitis E virus infection. HEV: Hepatitis E virus; IgM: Immunoglobulin M.
Figure 4
Figure 4
Flowchart of treatment for hepatitis E virus infection.
See this image and copyright information in PMC

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