Hepatitis E

Definition

Hepatitis E isn’t as well known as the other viruses that cause hepatitis, an acute or chronic inflammation of liver tissue.

Hepatitis E usually resolves within weeks, but sometimes it causes acute liver failure, which may be fatal.

Epidemiology

Hepatitis  E infects an estimated 20 million people worldwide each year and kills more than 56,000, according to the Johns Hopkins Bloomberg School of Public Health (data from 2017).

Periodic outbreaks occur in places like India, Pakistan, Nepal, Bangladesh, and regions of Africa, where poor sanitation and water quality problems can infect hundreds of thousands of people at a time through a fecal-oral route.

Mortality hepatitis E
Pregnant women are especially vulnerable, with up to 30 percent dying after becoming infected through a mechanism that’s currently not understood by researchers. In contrast, the overall mortality rate for hepatitis E is about 1 percent.

Hepatitis E virus infection (HEV) is the most common cause of acute viral hepatitis worldwide, acording to Stellenbosch University.

Causes

Hepatitis E is caused by hepatitis E virus (HEV).

Symptoms

For some who contract the virus, symptoms are so mild that they’re unaware they are infected and shedding the virus in their stool.

Complications

HEV has the potential to become a chronic infection, especially in immunosuppressed patients. Transplant patients are also at risk for chronic infection, as they receive immunosuppressive therapy to minimise graft rejection.

Diagnosis

Currently (July 2017), the only ways to test for both recent and past hepatitis E is through a blood test that checks for antibodies to HEV or blood or stool tests that check for HEV genetic material. Both sample types can be difficult to collect from patients in the field, and evaluating them requires resources that are often limited in low- to middle-income countries.
A saliva test developed by researchers at the Johns Hopkins Bloomberg School of Public Health nearly matches the performance of a blood test widely used to assess recent or past hepatitis E virus (HEV) infection, a new study reports.
The paper was published in the July edition of the Journal of Immunological Methods. Researchers estimate it could be several years before they are able to make the test available.

Treatment

An infection with HEV heals spontaneously and without the need for medication in the majority of cases. Nevertheless, and as reported by the Swiss site Pharmavista.net in transplant patients, the prevalence of chronic hepatitis E is estimated to be between 1 and 3%.

World Hepatitis Day is commemorated on 28 July.

Sources:
Johns Hopkins Bloomberg School of Public Health (July 2017), Pharmavista.net, Stellenbosch University (South Africa)