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Review
. 2025 Feb;31(Suppl):S196-S204.
doi: 10.3350/cmh.2024.0758. Epub 2024 Nov 11.

Hepatitis E as a trigger for acute-on-chronic liver failure

Maria Buti  1   2   3 , Juan Carlos Ruiz-Cobo  1   2 , Rafael Esteban  1 , Mar Riveiro-Barciela  1   2   3   4
Affiliations
Review

Hepatitis E as a trigger for acute-on-chronic liver failure

Maria Buti et al. Clin Mol Hepatol. 2025 Feb.

Abstract

Acute hepatitis E virus (HEV) infection is typically self-limiting and has a favourable prognosis. However, certain populations such as patients with pre-existing chronic liver disease may experience severe manifestations, including progression to acute-on-chronic liver failure (ACLF). Among viral hepatitis types, hepatitis A, E, and B are major causes of ACLF. Active screening and early diagnosis of HEV infection in patients with cirrhosis, especially those who develop ACLF, can improve management and enable timely antiviral therapy. Preventive measures, including HEV vaccination for high-risk groups, could reduce the morbidity and mortality associated with hepatitis E.

Keywords: Acute on chronic liver failure; Hepatitis E; Liver cirrhosis; Ribavirin; Vaccination.

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Conflict of interest statement

Conflicts of Interest

Maria Buti advisory board and/or speakers’ bureau fees: AbbVie, Altimmune, Janssen, GlaxoSmithKline, Gilead and Roche; Grants: Gilead. Mar Riveiro-Barciela: advisory board and/or speakers’ bureau fees: Bristol Myers Squibb, Gilead, GlaxoSmithKline; Grants: Gilead.

Figures

Figure 1.
Figure 1.
Hepatitis E hosts and type of infection according to genotype. HEV, hepatitis E virus.
See this image and copyright information in PMC

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