Hepatitis E Virus

Hepatitis E Virus is a topic covered in the Washington Manual of Medical Therapeutics.

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HEV is an RNA virus from the Hepeviridae family. It is considered a zoonotic disease with reservoirs in pigs, wild boar, and deer. Transmission is fecal-oral, such as that of HAV, and HEV can occur in outbreaks. Acute hepatitis E is clinically indistinguishable from other acute viral hepatitis and is usually self-limited, with the exception of pregnancy (mortality can be as high as 10%–30% in the third trimester), preexisting chronic liver disease, and organ transplantation. Hepatitis E can rarely progress to chronic infection (HEV RNA for >6 months). Most cases have occurred in solid organ transplant recipients or immunosuppressed individuals (e.g., HIV). In a retrospective multicenter study of 59 transplant recipients with chronic hepatitis E, ribavirin monotherapy for 3 months achieved an SVR of 78%.1

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