Hepatitis E Virus: Epidemiology, Diagnosis, and Management

Nae-Yun Heo

doi:10.4166/kjg.2019.74.3.130

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Heo: Hepatitis E Virus: Epidemiology, Diagnosis, and Management

Review Article

The Korean Journal of Gastroenterology 2019; 74(3): 130-136.

Published online: 27 September 2019

DOI: https://doi.org/10.4166/kjg.2019.74.3.130

Hepatitis E Virus: Epidemiology, Diagnosis, and Management

Nae-Yun Heo

Division of Gastroenterology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Nae-Yun Heo, Division of Gastroenterology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea. Tel: +82-51-797-2446, Fax: +82-51-797-1340, nyheo@hanmail.net

Received 12 August 2019 Revised 27 August 2019 Accepted 28 August 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.

Keywords: Hepatitis E, Waterborne diseases, Zoonoses, Genotype

Figures and Tables

Fig. 1

Transmission route of hepatitis E virus genotype 1 and 2 (A), and genotype 3 and 4 (B).

Table 1

Epidemiological and Clinical Features of Hepatitis E Virus Infection according to Genotype

HEV-1, hepatitis E virus genotype 1; HEV-2, hepatitis E virus genotype 2; HEV-3, hepatitis E virus, genotype 3; HEV-4, hepatitis E virus genotype 4.

Notes

^{Financial support} None.

^{Conflict of interest} None.

References

1. Khuroo MS. Discovery of hepatitis E: the epidemic non-A, non-B hepatitis 30 years down the memory lane. Virus Res. 2011; 161:3–14.

2. Balayan MS, Andjaparidze AG, Savinskaya SS, et al. Evidence for a virus in non-A, non-B hepatitis transmitted via the fecal-oral route. Intervirology. 1983; 20:23–31.

3. Tam AW, Smith MM, Guerra ME, et al. Hepatitis E virus (HEV): molecular cloning and sequencing of the full-length viral genome. Virology. 1991; 185:120–131.

4. Yarbough PO, Tam AW, Fry KE, et al. Hepatitis E virus: identification of type-common epitopes. J Virol. 1991; 65:5790–5797.

5. Khuroo MS, Dar MY. Hepatitis E: evidence for person-to-person transmission and inability of low dose immune serum globulin from an Indian source to prevent it. Indian J Gastroenterol. 1992; 11:113–116.

6. Arankalle VA, Chadha MS, Mehendale SM, Tungatkar SP. Epidemic hepatitis E: serological evidence for lack of intrafamilial spread. Indian J Gastroenterol. 2000; 19:24–28.

7. Somani SK, Aggarwal R, Naik SR, Srivastava S, Naik S. A serological study of intrafamilial spread from patients with sporadic hepatitis E virus infection. J Viral Hepat. 2003; 10:446–449.

8. Khuroo MS, Kamili S, Khuroo MS. Clinical course and duration of viremia in vertically transmitted hepatitis E virus (HEV) infection in babies born to HEV-infected mothers. J Viral Hepat. 2009; 16:519–523.

9. Colson P, Borentain P, Queyriaux B, et al. Pig liver sausage as a source of hepatitis E virus transmission to humans. J Infect Dis. 2010; 202:825–834.

10. Berto A, Martelli F, Grierson S, Banks M. Hepatitis E virus in pork food chain, United Kingdom, 2009–2010. Emerg Infect Dis. 2012; 18:1358–1360.

11. Said B, Ijaz S, Chand MA, Kafatos G, Tedder R, Morgan D. Hepatitis E virus in England and Wales: indigenous infection is associated with the consumption of processed pork products. Epidemiol Infect. 2014; 142:1467–1475.

12. Tulen AD, Vennema H, van Pelt W, Franz E, Hofhuis A. A case-control study into risk factors for acute hepatitis E in the Netherlands, 2015–2017. J Infect. 2019; 78:373–381.

13. European Centre for Disease Prevention and Control. Hepatitis E in the EU/EEA, 2005–2015. Stockholm: European Centre for Disease Prevention and Control;2017.

14. Masuda J, Yano K, Tamada Y, et al. Acute hepatitis E of a man who consumed wild boar meat prior to the onset of illness in Nagasaki, Japan. Hepatol Res. 2005; 31:178–183.

15. Mizuo H, Yazaki Y, Sugawara K, et al. Possible risk factors for the transmission of hepatitis E virus and for the severe form of hepatitis E acquired locally in Hokkaido, Japan. J Med Virol. 2005; 76:341–349.

16. Tei S, Kitajima N, Takahashi K, Mishiro S. Zoonotic transmission of hepatitis E virus from deer to human beings. Lancet. 2003; 362:371–373.

17. Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008; 8:698–709.

18. Hewitt PE, Ijaz S, Brailsford SR, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014; 384:1766–1773.

19. Kim NJ, Lee JS, Kim KA, et al. A case of acute hepatitis E. Taehan Kan Hakhoe Chi. 2002; 8:312–316.

20. Kim SS, Yeo CD, Kim JD, et al. A case of acute hepatitis E with the travel history to an endemic area. Korean J Gastroenterol. 2004; 44:342–345.

21. Kong SJ, Min SK, Kim IK, et al. Two cases of acute hepatitis E in patients with hyperthyroidism. Korean J Gastroenterol. 2006; 47:65–71.

22. Lim JW, Park CS, Ahn JM, et al. Nine cases of sporadic acute hepatitis E in Korea. Korean J Hepatol. 2006; 12:230–236.

23. Lee JK, Kim YJ, Kim IK, et al. An influx case of acute hepatitis E from the endemic area. Korean J Med. 2008; 74:S74–S77.

24. Kim YM, Jeong SH, Kim JY, et al. The first case of genotype 4 hepatitis E related to wild boar in South Korea. J Clin Virol. 2011; 50:253–256.

25. Choi JY, Lee JM, Jo YW, et al. Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea. Clin Mol Hepatol. 2013; 19:309–314.

26. Yun H, Kim JS, Lee HJ, et al. The complete genome sequence and molecular analysis of human hepatitis E virus genotype IV identified from a Korean patient. Arch Virol. 2010; 155:1003–1008.

27. Ji SB, Lee SS, Jung HC, et al. A Korean patient with Guillain-Barré syndrome following acute hepatitis E whose cholestasis resolved with steroid therapy. Clin Mol Hepatol. 2016; 22:396–399.

28. Ahn JM, Kang SG, Lee DY, Shin SJ, Yoo HS. Identification of novel human hepatitis E virus (HEV) isolates and determination of the seroprevalence of HEV in Korea. J Clin Microbiol. 2005; 43:3042–3048.

29. Kim BS, Lim HS, Lee K, Min YS, Yoon YS, Jeong HS. A survey on the status of hepatitis e virus infection among slaughterhouse workers in South Korea. J Prev Med Public Health. 2015; 48:53–61.

30. Kim YH, Park BJ, Ahn HS, et al. Detection of hepatitis E virus genotypes 3 and 4 in pig farms in Korea. J Vet Sci. 2018; 19:309–312.

31. Song YJ, Jeong HJ, Kim YJ, et al. Analysis of complete genome sequences of swine hepatitis E virus and possible risk factors for transmission of HEV to humans in Korea. J Med Virol. 2010; 82:583–591.

32. Dalton HR, Izopet J, Bendall R, Hepatitis E. Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, editors. Zakim and Boyer's hepatology. 7th ed. Philadelphia (PA): Elsevier;2018. p. 522–534.

33. European Association for the Study of the Liver. EASL clinical practice guidelines on hepatitis E virus infection. J Hepatol. 2018; 68:1256–1271.

34. Legrand-Abravanel F, Kamar N, Sandres-Saune K, et al. Characteristics of autochthonous hepatitis E virus infection in solid-organ transplant recipients in France. J Infect Dis. 2010; 202:835–844.

35. Abravanel F, Lhomme S, Chapuy-Regaud S, et al. Hepatitis E virus reinfections in solid-organ-transplant recipients can evolve into chronic infections. J Infect Dis. 2014; 209:1900–1906.

36. Kamar N, Garrouste C, Haagsma EB, et al. Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants. Gastroenterology. 2011; 140:1481–1489.

37. Woolson KL, Forbes A, Vine L, et al. Extra-hepatic manifestations of autochthonous hepatitis E infection. Aliment Pharmacol Ther. 2014; 40:1282–1291.

38. van Eijk JJJ, Dalton HR, Ripellino P, et al. Clinical phenotype and outcome of hepatitis E virus-associated neuralgic amyotrophy. Neurology. 2017; 89:909–917.

39. Mansuy JM, Legrand-Abravanel F, Calot JP, et al. High prevalence of anti-hepatitis E virus antibodies in blood donors from South West France. J Med Virol. 2008; 80:289–293.

40. Mansuy JM, Bendall R, Legrand-Abravanel F, et al. Hepatitis E virus antibodies in blood donors, France. Emerg Infect Dis. 2011; 17:2309–2312.

41. Hyams C, Mabayoje DA, Copping R, et al. Serological cross reactivity to CMV and EBV causes problems in the diagnosis of acute hepatitis E virus infection. J Med Virol. 2014; 86:478–483.

42. Kang HM, Jeong SH, Kim JW, et al. Recent etiology and clinical features of acute viral hepatitis in a single center of Korea. Korean J Hepatol. 2007; 13:495–502.

43. Lee EJ, Kwon SY, Seo TH, et al. Clinical features of acute hepatitis A in recent two years. Korean J Gastroenterol. 2008; 52:298–303.

44. Baylis SA, Blümel J, Mizusawa S, et al. World Health Organization International Standard to harmonize assays for detection of hepatitis E virus RNA. Emerg Infect Dis. 2013; 19:729–735.

45. Al-Sadeq DW, Majdalawieh AF, Mesleh AG, Abdalla OM, Nasrallah GK. Laboratory challenges in the diagnosis of hepatitis E virus. J Med Microbiol. 2018; 67:466–480.

46. Kamar N, Mallet V, Izopet J. Ribavirin for chronic hepatitis E virus infection. N Engl J Med. 2014; 370:2447–2448.

47. Biliotti E, Franchi C, Spaziante M, et al. Autochthonous acute hepatitis E: treatment with sofosbuvir and ribavirin. Infection. 2018; 46:725–727.

48. van der Valk M, Zaaijer HL, Kater AP, Schinkel J. Sofosbuvir shows antiviral activity in a patient with chronic hepatitis E virus infection. J Hepatol. 2017; 66:242–243.

49. Hepnet pilot trial: multicenter trial for the treatment of chronic hepatitis E with sofosbuvir (SofE). [Internet]. Bethesda (MD): U.S. National Library of Medicine;2017. 09. 14. 2019 Mar 8. 2019 Aug 18. Available from: https://clinicaltrials.gov/ct2/show/NCT03282474.

50. Zhang J, Shih JW, Xia NS. Long-term efficacy of a hepatitis E vaccine. N Engl J Med. 2015; 372:2265–2266.

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ORCID iDs: Nae-Yun Heo
https://orcid.org/0000-0001-6571-8935
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