Hepatitis E virus and Zoonosis: Recent Advances and Therapeutic Implications

Abstract

Background: Hepatitis E is viral hepatitis caused by infection with the hepatitis E virus (HEV). Objective: This article aims to review HEV disease and recent advances in the management of hepatitis E. Methods: We used PubMed Clinical Queries and keywords of “hepatitis E”, “hepatitis E virus” AND “zoonosis” as the search engine. “Therapy”, “Clinical Prediction Guides”, “Diagnosis”, “Etiology” and “Prognosis” were used as filters, and “Narrow” scope was used. The search was conducted in April 2022. The information retrieved from the above search was used in the compilation of the present article. Results: Hepatitis E is viral hepatitis caused by infection with the hepatitis E virus (HEV). Hepatitis E has mainly a fecal-oral transmission route. Hepatitis E infection usually follows an acute and self-limiting course of illness with low death rates in resource-rich areas; however, it can be more severe in pregnant women and immunocompromised people. The mortality rates in these groups are substantially higher. A vaccine for HEV is available but is not universally approved. Ribavirin remains the most efficacious medication for the treatment of HEV but is contraindicated in pregnancy. Sofosbuvir and pegylated interferon, with or without ribavirin, have not been shown in the latest literature reviews to provide reliable additional benefits to the treatment of hepatitis. Sofosbuvir should not be used as monotherapy for HEV. Food is an important source of infection in many countries while rats are the primary vector in developing nations. Management must include an understanding of the rat habitats for this zoonotic disease. Conclusions: Hepatitis E remains an important cause of hepatitis and a zoonotic disease globally. Public health policies are key to containing this viral infectious disease, including policy in the transfusion of blood products.