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Review article: hepatitis E-a concise review of virology, epidemiology, clinical presentation and therapy.
Aliment Pharmacol Ther. 2017 07; 46(2):126-141.AP

Abstract

BACKGROUND

Hepatitis E virus (HEV) is a leading cause of acute icteric hepatitis and acute liver failure in the developing world. During the last decade, there has been increasing recognition of autochthonous (locally acquired) HEV infection in developed countries. Chronic HEV infection is now recognised, and in transplant recipients this may lead to cirrhosis and organ failure.

AIM

To detail current understanding of the molecular biology of HEV, diagnostic and therapeutic strategies and propose future directions for basic science and clinical research.

METHODS

PubMed was searched for English language articles using the key words "hepatitis E", "viral hepatitis", "autochthonous infection", "antiviral therapy", "liver transplantation", "acute", "chronic", "HEV", "genotype", "transmission" "food-borne", "transfusion". Additional relevant publications were identified from article reference lists.

RESULTS

There has been increasing recognition of autochthonous HEV infection in Western countries, mainly associated with genotype 3. Chronic HEV infection has been recognised since 2008, and in transplant recipients this may lead to cirrhosis and organ failure. Modes of transmission include food-borne transmission, transfusion of blood products and solid organ transplantation. Ribavirin therapy is used to treat patients with chronic HEV infection, but new therapies are required as there have been reports of treatment failure with ribavirin.

CONCLUSIONS

Autochthonous HEV infection is a clinical issue with increasing burden. Future work should focus on increasing awareness of HEV infection in the developed world, emphasising the need for clinicians to have a low threshold for HEV testing, particularly in immunosuppressed patients. Patients at potential risk of chronic HEV infection must also be educated and given advice regarding prevention of infection.

Authors+Show Affiliations

Department of Hepatology and Scottish Liver Transplant Unit, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK.Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK.Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro, UK.Department of Hepatology and Scottish Liver Transplant Unit, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.Department of Hepatology and Scottish Liver Transplant Unit, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28449246

Citation

Donnelly, M C., et al. "Review Article: Hepatitis E-a Concise Review of Virology, Epidemiology, Clinical Presentation and Therapy." Alimentary Pharmacology & Therapeutics, vol. 46, no. 2, 2017, pp. 126-141.
Donnelly MC, Scobie L, Crossan CL, et al. Review article: hepatitis E-a concise review of virology, epidemiology, clinical presentation and therapy. Aliment Pharmacol Ther. 2017;46(2):126-141.
Donnelly, M. C., Scobie, L., Crossan, C. L., Dalton, H., Hayes, P. C., & Simpson, K. J. (2017). Review article: hepatitis E-a concise review of virology, epidemiology, clinical presentation and therapy. Alimentary Pharmacology & Therapeutics, 46(2), 126-141. https://doi.org/10.1111/apt.14109
Donnelly MC, et al. Review Article: Hepatitis E-a Concise Review of Virology, Epidemiology, Clinical Presentation and Therapy. Aliment Pharmacol Ther. 2017;46(2):126-141. PubMed PMID: 28449246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: hepatitis E-a concise review of virology, epidemiology, clinical presentation and therapy. AU - Donnelly,M C, AU - Scobie,L, AU - Crossan,C L, AU - Dalton,H, AU - Hayes,P C, AU - Simpson,K J, Y1 - 2017/04/27/ PY - 2016/11/21/received PY - 2016/12/21/revised PY - 2017/03/30/accepted PY - 2017/4/28/pubmed PY - 2017/12/5/medline PY - 2017/4/28/entrez SP - 126 EP - 141 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 46 IS - 2 N2 - BACKGROUND: Hepatitis E virus (HEV) is a leading cause of acute icteric hepatitis and acute liver failure in the developing world. During the last decade, there has been increasing recognition of autochthonous (locally acquired) HEV infection in developed countries. Chronic HEV infection is now recognised, and in transplant recipients this may lead to cirrhosis and organ failure. AIM: To detail current understanding of the molecular biology of HEV, diagnostic and therapeutic strategies and propose future directions for basic science and clinical research. METHODS: PubMed was searched for English language articles using the key words "hepatitis E", "viral hepatitis", "autochthonous infection", "antiviral therapy", "liver transplantation", "acute", "chronic", "HEV", "genotype", "transmission" "food-borne", "transfusion". Additional relevant publications were identified from article reference lists. RESULTS: There has been increasing recognition of autochthonous HEV infection in Western countries, mainly associated with genotype 3. Chronic HEV infection has been recognised since 2008, and in transplant recipients this may lead to cirrhosis and organ failure. Modes of transmission include food-borne transmission, transfusion of blood products and solid organ transplantation. Ribavirin therapy is used to treat patients with chronic HEV infection, but new therapies are required as there have been reports of treatment failure with ribavirin. CONCLUSIONS: Autochthonous HEV infection is a clinical issue with increasing burden. Future work should focus on increasing awareness of HEV infection in the developed world, emphasising the need for clinicians to have a low threshold for HEV testing, particularly in immunosuppressed patients. Patients at potential risk of chronic HEV infection must also be educated and given advice regarding prevention of infection. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/28449246/Review_article:_hepatitis_E_a_concise_review_of_virology_epidemiology_clinical_presentation_and_therapy_ L2 - https://doi.org/10.1111/apt.14109 DB - PRIME DP - Unbound Medicine ER -