Thursday, March 28, 2024

Hepatitis E

Background

Hepatitis E is an enterically transmitted infection that is typically self-limited.
It is caused by the hepatitis E virus (HEV) and is spread by fecally contaminated water within endemic areas or through the consumption of uncooked or undercooked meat.
Outbreaks can be epidemic and individual. Hepatitis E has many similarities with hepatitis A. Hepatitis E has been associated with chronic hepatitis in solid-organ transplant recipients, patients infected by human immunodeficiency virus (HIV), and in an individual on rituximab treatment for non-Hodgkin lymphoma.
A study has shown that among patients receiving hemodialysis, the seroprevalence of anti-HEV immunoglobulin G (IgG) was found to be high. However, no evidence of chronic infection was found.

The course of infection has two phases, the prodromal phase and the icteric phase. The infection is self-limited. Whether protective immunoglobulins develop against future reinfection remains unknown. The overall case fatality rate is 4%, although pregnant women and liver transplant recipients may be at substantially higher risk.

Therapy should be predominantly preventive, relying on clean drinking water, good sanitation, and proper personal hygiene. A successful recombinant hepatitis E vaccine has been developed.

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