Abstract
Hepatitis E virus (HEV) infection results in nearly 20 million new infections, resulting in 70,000 deaths globally each year. Previously thought as a disease limited to developing nations with poor sanitation and hygiene, it is increasingly recognized that even the most developed nations are not spared. A clear dichotomy in epidemiology of HEV is noted between developing and industrialized nations. The HEV genotypes 1 and 2 are common in Asia and Africa and are transmitted mainly by contaminated drinking water. Sporadic as well as large-scale epidemics of acute hepatitis have been noted with HEV genotype 1 infection in developing countries of Asia and Africa. On the contrary, HEV genotypes 3 and 4 are common in industrialized nations and unlike genotypes 1 and 2, they are transmitted by consumption of raw meat products, fruits, and blood transfusion. Large epidemics have not been reported with HEV genotypes 3 and 4 and manifestation is usually indolent, though severe acute hepatitis has been reported.How to cite this article: Shrestha A, Gupta BP, Lama TK. Current Treatment of Acute and Chronic Hepatitis E Virus Infection: Role of Antivirals. Euroasian J Hepato-Gastroenterol 2017;7(1):73-77.
Highlights
How to cite this article: Shrestha A, Gupta BP, Lama TK
Pegylated interferon therapy for 3 months may be considered for liver transplant recipients with detectable Hepatitis E virus (HEV) ribonucleic acid (RNA) in serum and stool after 6 months of ribavirin therapy
In both developing and developed nations, HEV is an important cause of liver disease
Summary
Acute hepatitis E infection is usually a self-limiting illness lasting 1 to 3 months with spontaneous resolution. Since HEV manifests as self-limiting illness with very low mortality in low-risk population, specific antiviral therapies if any are not warranted. In selected high-risk population like pregnant women, people with underlying chronic liver diseases, and other comorbid illness, the mortality may be high as much as 25% and specific treatment against the virus if proven beneficial will be highly useful. The maximum duration of viremia and fecal shedding in genotype 1 HEV infection was found to be 120 days and 30 days respectively among healthy subjects.[4,5] Studies in North India, where HEV is endemic, failed to show persistence of HEV infection among transplant recipients.[6] a single case report from New Delhi claims chronic infection due to HEV genotype 1 leading to cirrhosis in a child with acute leukemia that received chemotherapy.[7].
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