Hepatitis E: Epidemiology and Natural History

Aggarwal, Rakesh

doi:10.1016/j.jceh.2013.05.010

Cited by 40 publications

(44 citation statements)

References 86 publications

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“…It causes large scale epidemics of AVH across the low-and middle income countries in Asia and Africa, and also causes sporadic cases of AVH in the same geographical region. 3,4 AVH due to HEV is usually an acute, self-limiting illness, similar in clinical presentation to AVH caused by hepatitis A virus (HAV). However, in two situations HEV may cause serious disease leading to high mortality: when AVH occurs in pregnant women which may rapidly worsen as acute liver failure, 5 and when AVH occurs in patients of chronic liver disease which may worsen as acute-on-chronic liver failure (ACLF).…”

Section: H Epatitis E Virus (Hev) Is a Small Non-enveloped Vi-mentioning

confidence: 99%

Hepatitis E and Acute-on-Chronic Liver Failure

Kumar

Saraswat

2013

Journal of Clinical and Experimental Hepatology

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Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis (AVH) globally. It causes large scale epidemics of AVH across the low-and middle income countries in Asia and Africa, and also causes sporadic cases of AVH in the same geographical region. AVH due to HEV is usually an acute, self-limiting illness, similar in clinical presentation to AVH caused by hepatitis A virus (HAV). When HEV causes AVH in patients of chronic liver disease it may worsen rapidly to a syndrome called acute-on-chronic liver failure (ACLF) leading to very high mortality. Acute deterioration of liver function in a patient with compensated chronic liver disease is the characteristic feature of ACLF. The typical disease course of patients with ACLF is the appearance of organ failure, which progresses to multi-organ failure and death. Many publications have reported HEV as one of the leading causes for ACLF from Asia and Africa, where HEV is endemic. The mortality rate of HEV-related ACLF (HEV-ACLF) ranges from 0% to 67% with a median being 34%. These patients require admission in the intensive care unit and they benefit from a team approach of clinicians with expertise in both hepatology and critical care. The goals of treatment are to prevent further deterioration in liver function, reverse precipitating factors, and support failing organs. Liver transplantation is required in selected patients to improve survival and quality of life. One preliminary report suggests that ribavirin may be an effective and safe drug for treatment of HEV-ACLF however this requires validation in large trials. ( J CLIN EXP HEPATOL 2013;3:225-230)

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Section: H Epatitis E Virus (Hev) Is a Small Non-enveloped Vi-mentioning

confidence: 99%

Hepatitis E and Acute-on-Chronic Liver Failure

Kumar

Saraswat

2013

Journal of Clinical and Experimental Hepatology

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“…Studies on different geographic areas have revealed the prevalence of acute HEV cases in different time periods as ranging from 9.4 to 71% from western, southern, eastern, and northern India [2]. Although sporadic cases are detected throughout the year, the outbreaks and high positivity of HEV generally occur during the monsoon and summer [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Detection of Genotype 1a and 1f of Hepatitis E Virus in Patients Treated at Tertiary Care Hospitals in Central India

Pathak¹,

Barde²

2017

Intervirology

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Background and Aims: An acute hepatitis, caused by hepatitis E virus (HEV), is a significant global health concern, especially in developing countries. HEV has 1 serotype and 8 genotypes, which are further divided into subtypes. Despite the availability of sporadic cases and outbreak data from India, specific information regarding HEV epidemiological data is lacking from central India. This study was conducted to understand epidemiological and molecular features of HEV in central India. Methods: In this 3-year study conducted from July 2012 to June 2015, IgM ELISA was used for the diagnosis of suspected HEV cases. For identifying the genotype, nRT PCR was conducted and the PCR products were sequenced and analysed. Clinical and demographic data were analysed using statistical tools to highlight the trends. Result: Out of 1,369 suspected cases, 341 (24.9%) were positive for HEV. The positivity was significantly higher in males (69.2%) and in the age group of > 15–45 years (72.5%). The HEV cases peaked during the summer. Subtypes 1a and 1f of genotype 1 were detected in the area during the study period. Conclusion: HEV is a major aetiological agent of viral hepatitis in central India with adults and males at higher risk of infection. Two subtypes of the virus were detected in the region. Continuous serological surveillance and molecular monitoring will help to understand the epidemiology of HEV infection, outbreak mitigation and aid in providing treatment.

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“…[3][4][5][6][7][8][9][10]18 The hepatitis E virus is predominantly transmitted through fecal contamination of water and food. 9,19 The contamination of water supply, in both rural (well water) and urban areas (water pipes) is responsible for outbreaks.…”

Section: Hepatitis E Virus Burdenmentioning

confidence: 99%

“…The epidemiology of HEV has been discussed in detail in the previous issue of this journal. 18 The epidemiology relevant to HEV-ALF in pregnancy will be discussed in this section.…”

Section: Hepatitis E Virus Burdenmentioning

confidence: 99%

“…18 Genotypes 3 and 4 are more prevalent in USA, Europe, and Japan where the reservoir seems to be represented by pigs, and zoonotic transmission is considered to be the cause of infection of human beings, leading to autochthonous acute HEV. Genotypes 3 and 4 have not been reported to be associated with severe liver disease and the majority of cases appear to represent subclinical infection.…”

Section: Effects Of Genotype Geographical Distribution and Pregnancymentioning

confidence: 99%

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