Abstract
Hepatitis E virus (HEV) infection is a polymorphic condition, present throughout the world and involving children and adults. Multiple studies over the last decade have contributed to a better understanding of the natural evolution of this infection in various population groups, several reservoirs and transmission routes being identified. To date, acute or chronic HEV-induced hepatitis has in some cases remained underdiagnosed due to the lower accuracy of serological tests and due to the evolutionary possibility with extrahepatic manifestations. Implementation of diagnostic tests based on nucleic acid analysis has increased the detection rate of this disease. The epidemiological and clinical features of HEV hepatitis differ depending on the geographical areas studied. HEV infection is usually a self-limiting condition in immunocompetent patients, but in certain categories of vulnerable patients it can induce a sudden evolution toward acute liver failure (pregnant women) or chronicity (immunosuppressed patients, post-transplant, hematological, or malignant diseases). In acute HEV infections in most cases supportive treatment is sufficient. In patients who develop chronic hepatitis with HEV, dose reduction of immunosuppressive medication should be the first therapeutic step, especially in patients with transplant. In case of unfavorable response, the initiation of antiviral therapy is recommended. In this review, the authors summarized the essential published data related to the epidemiological, clinical, paraclinical, and therapeutic aspects of HEV infection in adult and pediatric patients.
Highlights
The hepatitis E virus (HEV) was first characterized in detail in 1983 during an outbreak of non-A non-B, non-C hepatitis among Soviet soldiers on a military mission in Afghanistan [1]
In immunocompetent patients who develop severe forms of acute hepatitis with Hepatitis E virus (HEV), antiviral treatment with ribavirin for a period of 3 weeks is recommended
In patients with hematological disorders and chronic hepatitis with HEV, a sustained viral response was obtained according to published data, both after 3 months of monotherapy with Ribavirin and after a 3-month course of pegylated Interferon monotherapy [172, 173]
Summary
The hepatitis E virus (HEV) was first characterized in detail in 1983 during an outbreak of non-A non-B, non-C hepatitis among Soviet soldiers on a military mission in Afghanistan [1]. Genotypes HEV-3 and 4 are spread by zoonotic transmission through food, eating uncooked or undercooked flesh or liver from domestic pigs, wild boar, or Sika deer Another way is through the wastewater of domestic pig manure that pollutes the navigable waters and infects people who walk the sea beach or eat contaminated seafood [75, 76]. The fetuses and newborns of mothers with acute infection in the third trimester have a 50 and 100% risk of infection in endemic regions, because the placenta acts as a viral reservoir It was found in a recent study that in developing countries E virus infection may be responsible for >3,000 stillbirths each year, including fetal deaths due to maternal prenatal mortality.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
