RESEARCH PAPER
Hepatitis E – A new era in understanding
 
More details
Hide details
1
Department of Infectious Diseases, Medical University, Lublin, Poland
 
2
Clinical Research Association for Infectious Disease at the Department of Infectious Diseases, Medical University, Lublin, Poland
 
 
Corresponding author
Joanna Małgorzata Krzowska-Firych   

Department of Infectious Diseases, Medical University, Lublin, Staszica 16, 20-089 Lublin, Poland
 
 
Ann Agric Environ Med. 2018;25(2):250-254
 
KEYWORDS
TOPICS
ABSTRACT
Hepatitis E virus [HEV], the last of the five hepatotropic viruses to be discovered, was originally considered to cause an acute, travel-associated self-limiting illness restricted to humans; however, new research shows that there are animal reservoirs and zoonotic transmission. Additionally, HEV is now considered as a major health burden worldwide, leading to significant morbidity and mortality; therefore, the topic of hepatitis E is of re-emerging importance, having brought to light important questions such as the transmission of HEV, especially in developed countries, as well as treatment and vaccination options. HEV belongs to the genus Hepevirus in the Hepeviridae family. The HEV genome sequence is relatively stable; however, there is a diversity of genotypes which are helpful in comprehending the epidemiological phenomena. HEV is classified based on the nucleotide sequences of the genome and is now characterised as a single serotype with four major genotypes [HEV 1–4]. Hepatitis E cases are not clinically distinguishable from other types of acute viral hepatitis, although diagnosis can be strongly suspected in certain epidemiological settings. It is imperative to raise awareness among physicians about the importance of HEV, with the aim of helping recognise, prevent and treat HEV infections. This review article highlights the current developments of HEV in microbiology, epidemiology, clinical features, treatment and prophylaxis.
 
REFERENCES (43)
1.
Kumar S, Subhadra S, Singh B, Panda BK. Hepatitis E virus: the current scenario. Int J Infect Dis. 2013; 17(4): e228-e233.
 
2.
Li TC, Yang T, Shiota T, Yoshizaki S, Yoshida H, Saito M, Imagawa T, Malbas FF, Lupisan SP, Oshitani H, Wakita T. Molecular detection of hepatitis E virus in rivers in the Philippines. Am J Trop Med Hyg. 2014; 90(4): 764–766.
 
3.
Aggarwal RA. Hepatitis E: clinical presentation in disease-endemic areas and diagnosis. In Seminars in liver disease 2013; 33(1): 030–040. Thieme Medical Publishers.
 
4.
Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008; 8(11): 698–709.
 
5.
Balayan MS, Andjaparidze AG, Savinskaya SS, Ketiladze ES, Braginsky DM, Savinov AP, Poleschuk VF. Evidence for a virus in non-A, non-B hepatitis transmitted via the fecal-oral route. Intervirology 1983; 20(1): 23–31.
 
6.
Kalia M, Chandra V, Rahman SA, Sehgal D, Jameel S. Heparan sulfate proteoglycans are required for cellular binding of the hepatitis E virus ORF2 capsid protein and for viral infection. J Virol. 2009; 83(24): 12714–12724.
 
7.
Cao D, Meng XJ. Molecular biology and replication of hepatitis E virus. Emerg Microbes Infect. 2012; 1(8): e17.
 
8.
Pelosi E, Clarke I. Hepatitis E: a complex and global disease. Emerg Health Threats J. 2008; 1: e8.
 
9.
Meng XJ. Hepatitis E virus: animal reservoirs and zoonotic risk. Vet Microbiol. 2010; 140(3): 256–265.
 
10.
Johne R, Plenge-Bönig A, Hess M, Ulrich RG, Reetz J, Schielke A. Detection of a novel hepatitis E-like virus in faeces of wild rats using a nested broad-spectrum RT-PCR. J Gen Virol. 2010; 91(3): 750–758.
 
11.
Lukashev N, Drosten C, Müller MA, Ulrich RG, Leroy EM, Osterman A, Rasche A, Adam A, Adu-Sarkodie SKO, Kalko EK, Zerbinati FGR. Bats Worldwide Carry Hepatitis E. J. Virol 2012; 86(17): 9134.
 
12.
Zhao C, Ma Z, Harrison TJ. A novel genotype of hepatitis E virus prevalent among farmed rabbits in China. J Med Virol. 2009; 81(8): 1371–1379.
 
13.
Woo PC, Lau SK, Teng JL, Tsang AK, Joseph M, Wong EY, Tang Y, Sivakumar S, Xie J, Bai R, Wernery R. New hepatitis E virus genotype in camels, the Middle East. Emerg Infect Dis. 2014; 20(1044): 8.
 
14.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, AlMazroa MA. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380(9859): 2095–2128.
 
15.
Vishwanathan R. Infectious hepatitis in Delhi (1955–1956): a critical study—epidemiology. Indian J Med Res. 1957; 45 (Suppl 1): 1–29.
 
16.
Bura M, Michalak M, Chojnicki M, Czajka A, Kowala-Piaskowska A, Mozer-Lisewska I. Seroprevalence of anti-HEV IgG in 182 Polish patients. Postep Hig Med Dosw. 2015; 69: 320–326.
 
17.
Larska M, Krzysiak MK, Jabłoński A, Kęsik J, Bednarski M, Rola J. Hepatitis E virus antibody prevalence in wildlife in Poland. Zoonoses Public Health. 2015; 62(2): 105–110.
 
18.
Berto A, Martelli F, Grierson S, Banks M. Hepatitis E virus in pork food chain, United Kingdom, 2009–2010. Emerg Infect Dis. 2012; 18(8): 1358–1360.
 
19.
Di Bartolo I, Diez-Valcarce M, Vasickova P, Kralik P, Hernandez M, Angeloni G, Ostanello F, Bouwknegt M, Rodríguez-Lázaro D, Pavlik I, Ruggeri FM. Hepatitis E virus in pork production chain in Czech Republic, Italy, and Spain, 2010. Emerg Infect Dis. 2012; 18(8): 1282–1289.
 
20.
Ijaz S, Said B, Boxall E, Smit E, Morgan D, Tedder RS. Indigenous hepatitis E in England and Wales from 2003 to 2012: evidence of an emerging novel phylotype of viruses. J Infect Dis. 2014; 209(8): 1212–1218.
 
21.
Drobeniuc J, Favorov MO, Shapiro CN, Bell BP, Mast EE, Dadu A, Culver D, Iarovoi P, Robertson BH, Margolis HS. Hepatitis E virus antibody prevalence among persons who work with swine. J Infect Dis. 2001; 184(12): 1594–1597.
 
22.
Balayan MS, Andjaparidze AG, Savinskaya SS, Ketiladze ES, Braginsky DM, Savinov AP, Poleschuk VF. Evidence for a virus in non-A, non-B hepatitis transmitted via the fecal-oral route. Intervirol. 1983; 20(1): 23–31.
 
23.
Pavio N, Meng XJ, Renou C. Zoonotic hepatitis E: animal reservoirs and emerging risks. Veterinary research 2010; 41(6): 46.
 
24.
Colson P, Coze C, Gallian P, Henry M, De Micco P, Tamalet C. Transfusion-associated hepatitis E, France. Transfusion. 2007.
 
25.
Mitsui T, Tsukamoto Y, Yamazaki C, Masuko K, Tsuda F, Takahashi M, Nishizawa T, Okamoto H. Prevalence of hepatitis E virus infection among hemodialysis patients in Japan: evidence for infection with a genotype 3 HEV by blood transfusion. J Med Virol. 2004; 74(4): 563–572.
 
26.
Krumbholz A, Neubert A, Joel S, Girschick H, Huppertz HI, Kaiser P, Liese J, Streng A, Niehues T, Peters J, Sauerbrey A. Prevalence of hepatitis E virus antibodies in children in Germany. Pediatr Infect Dis J. 2014; 33(3): 258–262.
 
27.
Labrique AB, Kuniholm MH, Nelson KE. The global impact of hepatitis E: new horizons for an emerging virus. In Emerging infections 2010; 53–93. American Society of Microbiology.
 
28.
Bhatia V, Singhal A, Panda SK, Acharya SK. A 20‐year single‐center experience with acute liver failure during pregnancy: Is the prognosis really worse? Hepatology. 2008; 48(5): 1577–1585.
 
29.
Kamar N, Bendall RP, Peron JM, Cintas P, Prudhomme L, Mansuy JM, Rostaing L, Keane F, Ijaz S, Izopet J. Hepatitis E virus and neurologic disorders. Emerg Infect Dis. 2011; 17: 173–179.
 
30.
Aggarwal R, Naik S. Epidemiology of hepatitis E: current status. J Gastroenterol Hepatol. 2009; 24(9): 1484–1493.
 
31.
Aggarwal R. Diagnosis of hepatitis E. Nat Rev Gastroenterol Hepatol. 2013; 10(1): 24–33.
 
32.
Mirazo S, Ramos N, Mainardi V, Gerona S, Arbiza J. Transmission, diagnosis, and management of hepatitis E: an update. Hepat Med. 2014; 6: 45–59.
 
33.
Aggarwal R. Clinical presentation of hepatitis E. Virus Res. 2011; 161(1): 15–22.
 
34.
Halac U, Béland K, Lapierre P, Patey N, Ward P, Brassard J, Houde A, Alvarez F. Cirrhosis due to chronic hepatitis E infection in a child post-bone marrow transplant. J Paediatr. 2012; 160(5): 871–874.
 
35.
Gerolami R, Borentain P, Raissouni F, Motte A, Solas C, Colson P. Treatment of severe acute hepatitis E by ribavirin. J Clin Virol. 2011; 52(1): 60–62.
 
36.
Kamar N, Izopet J, Tripon S, Bismuth M, Hillaire S, Dumortier J, Radenne S, Coilly A, Garrigue V, D’Alteroche L, Buchler M. Ribavirin for chronic hepatitis E virus infection in transplant recipients. N Engl J Med. 2014; 370(12): 1111–1120.
 
37.
Shrestha MP, Scott RM, Joshi DM, Mammen Jr MP, Thapa GB, Thapa N, Myint KSA, Fourneau M, Kuschner RA, Shrestha SK, David MP. Safety and efficacy of a recombinant hepatitis E vaccine. N Engl J Med. 2007; 356(9): 895–903.
 
38.
Shrestha MP, Scott RM, Joshi DM, Mammen Jr, MP, Thapa GB, Thapa N, Myint KSA, Fourneau M, Kuschner, RA, Shrestha SK, David MP. Safety and efficacy of a recombinant hepatitis E vaccine. N Engl J Med. 2007; 356(9): 895–903.
 
39.
Li SW, Zhang J, Li YM, Ou SH, Huang GY, He ZQ, Sheng XG, Xian YL, Pang SQ, Ng MH, Xia NS. A bacterially expressed particulate hepatitis E vaccine: antigenicity, immunogenicity and protectivity on primates. Vaccine 2005; 23(22): 2893–2901.
 
40.
Zhang J, Liu CB, Li RC, Li YM, Zheng YJ, Li YP, Luo D, Pan BB, Nong Y, Ge SX, Xiong JH. Randomized-controlled phase II clinical trial of a bacterially expressed recombinant hepatitis E vaccine. Vaccine 2009; 27(12): 1869–1874.
 
41.
Zhu FC, Zhang J, Zhang XF, Zhou C, Wang ZZ, Huang SJ, Wang H, Yang L, Jiang HM, Cai JP, Wang YJ. Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large-scale, randomised, double-blind placebo-controlled, phase 3 trial. Lancet 2010; 376(9744): 895–902.
 
42.
Scobie L, Dalton HR. Hepatitis E: source and route of infection, clinical manifestations and new developments. J Viral Hepat. 2013; 20(1): 1–11.
 
43.
Barnaud E, Rogée S, Garry P, Rose N, Pavio N. Thermal inactivation of infectious hepatitis E virus in experimentally contaminated food. Appl Environ Microbiol. 2012; 78(15): 5153–5159.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top