Abstract
Outbreaks and sporadic cases of Hepatitis E virus (HEV) are well known. But, chronic disease leading to cirrhosis is increasingly recognized in immunocompetent and immunosuppressed individuals. Transmission is commonly by the feco-oral route; but zoonotic, vertical and transfusion related transmission is also documented. Most HEV infections are either asymptomatic or present as acute self-limited viral hepatitis with a prominent cholestatic phase. Fulminant hepatic failure is a dreaded complication in pregnancy, underlying liver disease and immuno-suppressed patients including organ transplant recipients. Several other systemic complications are reported infrequently. Co-infections with other hepatitis viruses, HIV, EBV, salmonella, leptospira, etc; worsen the outcomes. Co- morbidities like alcoholism, chronic liver disease, sickle cell disease, collagen–vascular diseases and malignancy also alter the clinical course. Ribavirin and mycophenolate are showing promise in treatment of prolonged HEV infections in by preventing cirrhosis; and in transplant recipients by improving outcomes. Routine screening for transfusion safety is an issue, when it comes to cost of health care. An effective vaccine has been licensed for use in China.
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