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. 2024 Aug;54(8):1-30.
doi: 10.1111/hepr.14062. Epub 2024 Jun 14.

Recent advances in hepatitis E virus research and the Japanese clinical practice guidelines for hepatitis E virus infection

Tatsuo Kanda  1   2   3 , Tian-Cheng Li  4 , Masaharu Takahashi  5 , Shigeo Nagashima  5 , Putu Prathiwi Primadharsini  5 , Satoshi Kunita  6 , Reina Sasaki-Tanaka  1   3 , Jun Inoue  7 , Atsunori Tsuchiya  3 , Shingo Nakamoto  8 , Ryuzo Abe  9 , Keiichi Fujiwara  8 , Osamu Yokosuka  8 , Ryosuke Suzuki  4 , Koji Ishii  10 , Hiroshi Yotsuyanagi  11   12 , Hiroaki Okamoto  5 ; AMED HAV and HEV Study Group
Collaborators, Affiliations

Recent advances in hepatitis E virus research and the Japanese clinical practice guidelines for hepatitis E virus infection

Tatsuo Kanda et al. Hepatol Res. 2024 Aug.

Abstract

Acute hepatitis E was considered rare until reports emerged affirming the existence of hepatitis E virus (HEV) genotypes 3 and 4 infections in Japan in the early 2000s. Extensive studies by Japanese researchers have highlighted the pivotal role of pigs and wild animals, such as wild boars and deer, as reservoirs for HEV, linking them to zoonotic infections in Japan. Currently, when hepatitis occurs subsequent to the consumption of undercooked or grilled pork, wild boar meat, or offal (including pig liver and intestines), HEV infection should be considered. Following the approval of anti-HEV immunoglobulin A antibody as a diagnostic tool for hepatitis E by Japan's Health Insurance System in 2011, the annual number of diagnosed cases of HEV infection has surged. Notably, the occurrence of post-transfusion hepatitis E promoted nationwide screening of blood products for HEV using nucleic acid amplification tests since 2020. Furthermore, chronic hepatitis E has been observed in immunosuppressed individuals. Considering the significance of hepatitis E, heightened preventive measures are essential. The Japan Agency for Medical Research and Development Hepatitis A and E viruses (HAV and HEV) Study Group, which includes special virologists and hepatologists, held a virtual meeting on February 17, 2024. Discussions encompassed pathogenesis, transmission routes, diagnosis, complications, severity factors, and ongoing and prospective vaccination or treatments for hepatitis E. Rigorous assessment of referenced studies culminated in the formulation of recommendations, which are detailed within this review. This comprehensive review presents recent advancements in HEV research and Japanese clinical practice guidelines for HEV infection.

Keywords: Japan Agency for Medical Research and Development; chronic infection; current and future research; guideline; hepatitis E virus.

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