Hepatitis E is a liver disease caused by the hepatitis E virus (HEV). HEV infection results in a self-limited, acute illness. Acute infection can become chronic in rare cases, primarily in people who have had organ transplants.
Causes
HEV is usually spread by contaminated food, dirty water, and feces. In developing countries, where HEV genotypes 1 and 2 predominate, the most common source of HEV infection is contaminated drinking water. In developed countries, sporadic cases of HEV genotype 3 have occurred following the consumption of
- Uncooked/undercooked pork or deer meat.
- Consumption of shellfish was a risk factor in an outbreak among cruise ship passengers.
Many people with these do not have symptoms of acute infection. In developing countries, symptomatic hepatitis E commonly occurs among older adolescents and young adults. Pregnant women are more likely to experience severe illness, including fulminant hepatitis and death.
When symptoms occur, they usually develop 15–60 days after exposure.
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Symptoms
The signs and symptoms of these are similar to those of other types of acute viral hepatitis and liver injury. They include:
- Fever
- Fatigue
- Loss of appetite
- Nausea
- Vomiting
- Abdominal pain
- Jaundice
- Dark urine
- Clay-colored stool
- Joint pain
Facts
It is most common in developing countries with an inadequate water supply and poor environmental sanitation. Hepatitis E epidemics involving large numbers of people have been reported in Asia, the Middle East, Africa, and Central America. People living in crowded camps or temporary housing, including refugees and people who are internally displaced, are at particularly high risk.
Risk Factors
Most people with hepatitis E recover completely.
- During these outbreaks, the overall case-fatality rate is about 1%. However,
- For pregnant women, hepatitis E can be a serious illness, with mortality reaching 10%–30%
- Hepatitis E can also pose serious health threats to people with preexisting chronic liver disease and organ-transplant recipients on immunosuppressive therapy, resulting in decompensated liver disease and death.
- To date, there is no report of the progression of acute hepatitis E to chronic hepatitis E in developing countries, where HEV genotypes 1 and 2 are the predominant causes of illness. However,
- Increasing numbers of these genotype 3 infections acquired in developed countries are progressing to cause chronic hepatitis and chronic liver disease. These chronic cases occur mainly among solid-organ transplant recipients receiving immunosuppressive treatment.
Diagnosis and Treatment
Because cases of hepatitis E are not clinically distinguishable from other types of acute viral hepatitis, diagnosis can be confirmed only by testing for the presence of antibodies against HEV or HEV RNA. Both serologic and nucleic acid tests are commercially available.
Treatment
It usually resolves on its own without treatment. There is no specific antiviral therapy for acute hepatitis E.
- It usually resolves on its own without treatment. There is no specific antiviral therapy for acute hepatitis E.
- Supportive therapy.
- Bed rest, get adequate nutrition and fluids, avoid alcohol, and check with their physician before taking any medications that can damage the liver.
- Hospitalization is required in severe cases and should be considered for pregnant women.
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Prevention
Prevention of this relies primarily on good sanitation and the availability of clean drinking water.
- Travelers to developing countries can reduce their risk of infection by not drinking unpurified water.
- Boiling and chlorination of water will inactivate HEV.
- Avoiding raw pork and venison can reduce the risk of HEV genotype 3 transmissions.
- Immune globulin is not effective in preventing It.
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