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Advances in hepatitis E - II: Epidemiology, clinical manifestations, treatment and prevention.
Expert Rev Gastroenterol Hepatol. 2016 Sep; 10(9):1065-74.ER

Abstract

INTRODUCTION

Infection with hepatitis E virus (HEV) is the commonest cause of acute hepatitis worldwide. This infection, with fecal-oral transmission, was previously thought to be limited to humans residing in developing countries with poor sanitation, spreading via contaminated drinking water. In recent years, our understanding of epidemiology and clinical spectrum of this infection have changed markedly.

AREAS COVERED

This article reviews the epidemiology, including routes of transmission, and clinical manifestations of HEV infection around the world. In addition, recent findings on transmission-associated HEV infection, extrahepatic manifestations of hepatitis E and chronic infection with HEV, and treatment and prevention of this infection are discussed. Expert commentary: HEV infection has two distinct epidemiologic forms and clinical patterns of disease: (i) acute epidemic or sporadic hepatitis caused by fecal-oral (usually water-borne) transmission of genotype 1 and 2 HEV from a human reservoir in areas with poor hygiene and frequent water contamination, and (ii) infrequent sporadic hepatitis E caused by zoonotic infection, possibly from an animal source through ingestion of undercooked animal meal, of genotype 3 or 4 virus. In disease-endemic areas, pregnant women are at a particular risk of serious disease and high mortality. In less-endemic areas, chronic infection with HEV among immunosuppressed persons is observed. HEV can also be transmitted through Transfusion of blood and blood products. Ribivirin treatment is effective in chronic hepatitis E. Two efficacious vaccines have been tried in humans; one of these has received marketing approval in its country of origin.

Authors+Show Affiliations

a Department of Gastroenterology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.a Department of Gastroenterology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27148907

Citation

Goel, Amit, and Rakesh Aggarwal. "Advances in Hepatitis E - II: Epidemiology, Clinical Manifestations, Treatment and Prevention." Expert Review of Gastroenterology & Hepatology, vol. 10, no. 9, 2016, pp. 1065-74.
Goel A, Aggarwal R. Advances in hepatitis E - II: Epidemiology, clinical manifestations, treatment and prevention. Expert Rev Gastroenterol Hepatol. 2016;10(9):1065-74.
Goel, A., & Aggarwal, R. (2016). Advances in hepatitis E - II: Epidemiology, clinical manifestations, treatment and prevention. Expert Review of Gastroenterology & Hepatology, 10(9), 1065-74. https://doi.org/10.1080/17474124.2016.1185365
Goel A, Aggarwal R. Advances in Hepatitis E - II: Epidemiology, Clinical Manifestations, Treatment and Prevention. Expert Rev Gastroenterol Hepatol. 2016;10(9):1065-74. PubMed PMID: 27148907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in hepatitis E - II: Epidemiology, clinical manifestations, treatment and prevention. AU - Goel,Amit, AU - Aggarwal,Rakesh, Y1 - 2016/05/20/ PY - 2016/5/6/entrez PY - 2016/5/6/pubmed PY - 2017/4/18/medline KW - Hepatitis E virus KW - clinical features KW - epidemiology KW - persistent infection KW - prevention KW - ribavirin KW - transfusion-transmitted infection KW - transmission of disease KW - treatment KW - vaccine SP - 1065 EP - 74 JF - Expert review of gastroenterology & hepatology JO - Expert Rev Gastroenterol Hepatol VL - 10 IS - 9 N2 - INTRODUCTION: Infection with hepatitis E virus (HEV) is the commonest cause of acute hepatitis worldwide. This infection, with fecal-oral transmission, was previously thought to be limited to humans residing in developing countries with poor sanitation, spreading via contaminated drinking water. In recent years, our understanding of epidemiology and clinical spectrum of this infection have changed markedly. AREAS COVERED: This article reviews the epidemiology, including routes of transmission, and clinical manifestations of HEV infection around the world. In addition, recent findings on transmission-associated HEV infection, extrahepatic manifestations of hepatitis E and chronic infection with HEV, and treatment and prevention of this infection are discussed. Expert commentary: HEV infection has two distinct epidemiologic forms and clinical patterns of disease: (i) acute epidemic or sporadic hepatitis caused by fecal-oral (usually water-borne) transmission of genotype 1 and 2 HEV from a human reservoir in areas with poor hygiene and frequent water contamination, and (ii) infrequent sporadic hepatitis E caused by zoonotic infection, possibly from an animal source through ingestion of undercooked animal meal, of genotype 3 or 4 virus. In disease-endemic areas, pregnant women are at a particular risk of serious disease and high mortality. In less-endemic areas, chronic infection with HEV among immunosuppressed persons is observed. HEV can also be transmitted through Transfusion of blood and blood products. Ribivirin treatment is effective in chronic hepatitis E. Two efficacious vaccines have been tried in humans; one of these has received marketing approval in its country of origin. SN - 1747-4132 UR - https://www.unboundmedicine.com/medline/citation/27148907/Advances_in_hepatitis_E___II:_Epidemiology_clinical_manifestations_treatment_and_prevention_ L2 - https://www.tandfonline.com/doi/full/10.1080/17474124.2016.1185365 DB - PRIME DP - Unbound Medicine ER -