Overview of clinical guidelines on the management of hepatitis E

Abstract

Perceptions of hepatitis E have transformed over the past decade. This infection was common only in some developing countries. It is known now that hepatitis E occurs in most high - income countries and is largely a zoonotic infection. The review analyzes the relevant key publications and recommendations on the diagnosis and treatment of hepatitis E. Theproblems of diagnosis, treatment and prevention of hepatitis E caused by genotypes 3 and 4 are highlighted. It is shown that with symptoms of acute hepatitis for hepatitis E virus infection (HEV) it is advisable to test not only travelers returning from areas endemic for 1 or 2 genotypes (Asia, Africa, Mexico) and pregnant women, but also all patients, after excluding other reasons for changing liver tests. Testing for HEV is also recommended for patients with chronic liver disease with unexplained deterioration, for patients with immunosuppression and changes of liver tests, for patients with systemic manifestations of diseases of the nervous system. A combination of serological testing and nucleic acid amplification methods are recommended for the diagnosis of HEV infection. Treatment of HEV infection includes the use of antiviral therapy in severe cases; if possible, for patients who underwent transplantation of solid organs - a reduction in doses of immunosuppressive drugs for pregnant women - intensive therapy. Prevention of HEV infection is aimed at people with chronic liver diseases and receiving immunosuppressive therapy who should be excluded from the use of mollusks and poorly fried pig, boar and deer meat.