Hepatitis E virus: epidemiology, diagnosis, pathology and prevention

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.
Tropical gastroenterology: official journal of the Digestive Diseases Foundation 11/2005; 27(2):63-8.
Source: PubMed


HEV, a positive stranded RNA virus, is responsible for most of the epidemics of hepatitis in the developing world and is transmitted through contaminated water. It is the major aetiological agent for acute hepatitis and acute liver failure in endemic regions. It causes severe liver disease among pregnant females and patients with chronic liver disease. Serodiagnosis of HEV is now available and should be used routinely for diagnosis. The available evidence suggests that HEV may also be transmitted parenterally as well as vertically particularly in endemic areas. Experimental studies suggest that an HEV vaccine is a distinct possibility in the near future. In the absence of an effective vaccine, public health measures such as clean water supply, improved sanitation and public education are the major tools to prevent HEV epidemics in developing nations.

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    • "HEV has been considered as an amphixenosis. It once was a pandemic disease in Xinjiang Province, China [9] . HEV is one of the common types in sporadic viral hepatitis. "
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    ABSTRACT: To investigate the seroepidemiology and genetic characterization of hepatitis E virus (HEV) in western Yunnan Province. Questionnaire survey was conducted among 1638 residents in western Yunnan Province using stratified sampling method. Enzyme-linked immunosorbent assay was used to detect serum anti-HEV IgG and IgM. HEV RNA was extracted from patients with serum anti-HEV IgM positive. The open reading flame 2 (ORF2) of HEV that was amplified by nested RT-PCR was sequenced and compared with standard HEV genotypes 1-4. Serum anti-HEV positive was found in 13.92% (228/1638) residents. The HEV infection rate in males was significantly higher than that in females with a ratio of 1.47 (P<0.01). 20-30 and 30-40 years old young men showed the highest incidence, 20.57% and 20.78%, respectively. While 10-20 and 20-30 years old young women exhibited the highest infection rate, 11.85% and 15.60%, respectively. According to occupation, the highest HEV infection rate was observed in farmers (20.35%) and migrants (16.50%). We isolated 10 individual HEV isolates from 31 patients with serum anti-HEV IgM positive. Homology analysis and phylogenetic analysis indicated that these 10 HEV isolates belonged to HEV genotype 4 with the homology of 78.65%-94.71%. The HEV infection rate is high in western Yunnan Province. HEV genotype 4 is the leading cause of HEV infection and young farmers and migrants are the main infected population. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.
    Full-text · Article · Nov 2014 · Asian Pacific Journal of Tropical Medicine
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    • "Transmission of HEV occurs primarily by the fecal-oral route through fecal contamination of drinking water in developing countries. HEV may also be transmitted parenterally as well as vertically particularly in endemic areas (10), but person to person transmission is uncommon (1). Recent studies have indicated that zoonosis is involved in the transmission of HEV, especially in industrialized countries (11, 12). "
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    ABSTRACT: Hepatitis E virus (HEV) is a major public health concern in developing countries. HEV transmission occurs primarily by the fecal-oral route. It has also been reported that blood donors are potentially able to cause transfusion-associated hepatitis E in endemic areas. This study aimed to determine the seroprevalence of HEV infection among volunteer blood donors in Central province of Iran in 2012. A total of 530 consecutive blood donor samples collected from Blood Transfusion Organization, Central Province of Iran. All samples were tested for the presence of IgG Hepatitis E antibody (anti-HEV) using enzyme-linked immunosorbent assay (ELISA). From 530 blood donors, 91.9% were male and 8.1% were female. Overall, anti-HEV was found in 76 of 530 samples (14.3%). There was no significant difference in HEV seropositivity between the subjects regarding gender and area of residence (urban vs. rural). Anti-HEV was distributed among all age groups. Although people aged 31-50 years had the highest prevalence, but there was no statistical difference between the age groups. This study shows a relatively high prevalence of anti-HEV in the blood donors of Central province of Iran. More investigations are needed to assess the potential benefit of adding HEV screening of blood products to the current blood donor selection criteria.
    Full-text · Article · Jun 2013
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    • "All swine isolates belong to genotype 3 and 4 and no animal isolates to date belong to genotype 1 and 2. This may indicate that genotype 1 and 2 may not be capable of crossing the species barrier whereas genotype 3 and 4 can do so. On the other hand, genotype 1 and 2 cause severe liver disease whereas genotype 3 and 4 cause milder disease [1] [2]. It is further evident by the observation that the seroprevalence of anti-HEV in populations belonging to developed nations varies from 5–21% [18], indicating frequent exposure but epidemic outbreaks and the low frequency of autochthonous hepatitis would suggest that these viruses may be more benign than those prevalent in hyper-endemic region. "

    Full-text · Article · Sep 2010 · Journal of Hepatology
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