A Review of Hepatitis E Virus†

2001 ◽  
Vol 64 (4) ◽  
pp. 572-586 ◽  
Author(s):  
JAMES L. SMITH
Keyword(s):  
Death Rate ◽  
Hepatitis E Virus ◽  
Swine Manure ◽  
Hepatitis E ◽  
The United States ◽  
Disease Diagnosis ◽  
Oral Route ◽  
Premature Delivery ◽  
Industrialized Countries ◽  
Human Virus

Hepatitis E virus (HEV) is a major cause of outbreaks and sporadic cases of viral hepatitis in tropical and subtropical countries but is infrequent in industrialized countries. The virus is transmitted by the fecal-oral route with fecally contaminated drinking water being the usual vehicle. Hepatitis resulting from HEV infection is a moderately severe jaundice that is self-limiting in most patients. Young adults, 15 to 30 years of age, are the main targets of infection, and the overall death rate is 0.5 to 3.0%. However, the death rate during pregnancy approaches 15 to 25%. Death of the mother and fetus, abortion, premature delivery, or death of a live-born baby soon after birth are common complications of hepatitis E infection during pregnancy. Hepatitis E virus is found in both wild and domestic animals; thus, HEV is a zoonotic virus. The viruses isolated from swine in the United States or Taiwan are closely related to human HEV found in those areas. The close genetic relationship of the swine and human virus suggests that swine may be a reservoir of HEV. In areas where swine are raised, swine manure could be a source of HEV contamination of irrigation water or coastal waters with concomitant contamination of produce or shellfish. Increasing globalization of food markets by industrialized countries has the potential of introducing HEV into new areas of the world. The purpose of this review is to cover certain aspects of hepatitis E including the causative agent, the disease, diagnosis, viral detection, viral transmission, epidemiology, populations targeted by HEV, and the role of animals as potential vectors of the virus.

scholarly journals Mechanism of Cross-Species Transmission, Adaptive Evolution and Pathogenesis of Hepatitis E Virus

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 909
Author(s):  
Putu Prathiwi Primadharsini ◽  
Shigeo Nagashima ◽  
Hiroaki Okamoto
Keyword(s):  
Adaptive Evolution ◽  
Hepatitis E Virus ◽  
Current Knowledge ◽  
Hepatitis E ◽  
Oral Route ◽  
Open Reading Frames ◽  
Industrialized Countries ◽  
Zoonotic Infection ◽  
Host Determinants ◽  
Viral Determinants

Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. While the transmission in developing countries is dominated by fecal-oral route via drinking contaminated water, the zoonotic transmission is the major route of HEV infection in industrialized countries. The discovery of new HEV strains in a growing number of animal species poses a risk to zoonotic infection. However, the exact mechanism and the determinant factors of zoonotic infection are not completely understood. This review will discuss the current knowledge on the mechanism of cross-species transmission of HEV infection, including viral determinants, such as the open reading frames (ORFs), codon usage and adaptive evolution, as well as host determinants, such as host cellular factors and the host immune status, which possibly play pivotal roles during this event. The pathogenesis of hepatitis E infection will be briefly discussed, including the special forms of this disease, including extrahepatic manifestations, chronic infection, and fulminant hepatitis in pregnant women.

Hepatitis E Virus Infection in an Immigrant to the United States

1996 ◽  
Vol 89 (10) ◽  
pp. 994-996 ◽  
Author(s):  
DAVID L. SMALLEY ◽  
SUSAN C. BREWER ◽  
GEORGE J. DAWSON ◽  
CHARLES KYRK ◽  
BRADFORD WATERS
Keyword(s):  
United States ◽  
Virus Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
The United States

scholarly journals Hepatitis E Virus Immunopathogenesis

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1180
Author(s):  
Kush Kumar Yadav ◽  
Scott P. Kenney
Keyword(s):  
Hepatitis E Virus ◽  
Organ Transplant ◽  
Hepatitis E ◽  
Oral Route ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
In Vivo Models ◽  
Transplant Patients

Hepatitis E virus is an important emerging pathogen producing a lethal impact on the pregnant population and immunocompromised patients. Starting in 1983, it has been described as the cause for acute hepatitis transmitted via the fecal–oral route. However, zoonotic and blood transfusion transmission of HEV have been reported in the past few decades, leading to the detailed research of HEV pathogenesis. The reason behind HEV being highly virulent to the pregnant population particularly during the third trimester, leading to maternal and fetal death, remains unknown. Various host factors (immunological, nutritional, hormonal) and viral factors have been studied to define the key determinants assisting HEV to be virulent in pregnant and immunocompromised patients. Similarly, chronic hepatitis is seen particularly in solid organ transplant patients, resulting in fatal conditions. This review describes recent advances in the immunopathophysiology of HEV infections in general, pregnant, and immunocompromised populations, and further elucidates the in vitro and in vivo models utilized to understand HEV pathogenesis.

Rat Hepatitis E Virus Linked to Severe Acute Hepatitis in an Immunocompetent Patient

2019 ◽  
Vol 220 (6) ◽  
pp. 951-955 ◽  
Author(s):  
Anton Andonov ◽  
Mark Robbins ◽  
Jamie Borlang ◽  
Jingxin Cao ◽  
Todd Hatchette ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Hepatitis E Virus ◽  
Genomic Sequence ◽  
Hepatitis E ◽  
The United States ◽  
Immunocompetent Patient ◽  
Health Concern ◽  
Animal Reservoir ◽  
Hepatitis Infection ◽  
Severe Acute Hepatitis

Abstract Hepatitis E virus (HEV) is a major public health concern in developing countries where the primary transmission is via contaminated water. Zoonotic HEV cases have been increasingly described in Europe, Japan, and the United States, with pigs representing the main animal reservoir of infection. We report an unusual acute hepatitis infection in a previously healthy man caused by a rat HEV with a considerably divergent genomic sequence compared with other rat HEV strains. It is possible that rat HEV is an underrecognized cause of hepatitis infection, and further studies are necessary to elucidate its potential risk and mode of transmission.

scholarly journals 290. Hepatitis E Virus Serostatus: A Retrospective Assessment of Demographics and Comorbidities to Assess High-risk Populations

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S158-S158
Author(s):  
Eric C Stone ◽  
Zerelda Esquer Garrigos ◽  
Muhammad R Sohail ◽  
Raymund R Razonable ◽  
John C O’Horo
Keyword(s):  
United States ◽  
Liver Disease ◽  
Hepatitis E Virus ◽  
Kidney Diseases ◽  
Hepatitis E ◽  
The United States ◽  
Population Based ◽  
Positive Serology ◽  
Serologic Testing ◽  
One Year

Abstract Background Demographic and epidemiologic characteristics of Hepatitis E virus (HEV) infected patients in the United States are not well-described. HEV infection may result in severe complications and lead to chronic infection and cirrhosis, especially in immunocompromised patients. There are no widely accepted guidelines for HEV screening and testing in the United States. Identifying traits of known seropositive patients and comorbidities may inform better screening and prevention strategies. In this study, we describe rates of liver disease, transplant status, chronic kidney diseases, and diabetes mellitus among patients serologically tested for HEV at our institution. Methods We retrospectively reviewed all patients for whom HEV IgM or IgG serologic testing was performed across the Mayo Clinic enterprise using the Advanced Cohort Explorer tool. For patients with any documented HEV serologic test, we abstracted baseline patient characteristics and underlying comorbidities at the time of testing. We then grouped subjects according to serologic testing results by antibody type. Survival at one year from date of testing was also assessed. Results A total of 979 unique subjects were identified. The preponderance of subjects was Caucasian (781, 79.8%). Of subjects tested for HEV with serology, 123 (12.6%) had any positive serology. Breakdown of baseline characteristics and selected comorbidities are summarized in Table 1. The largest proportion of subjects, 458 (46.8%), were both IgG and IgM negative and 432 subjects received only IgM or IgG testing. Liver disease was more prevalent in patients with positive vs. negative testing (5.8% vs. 2.1%) as was higher age (average 55.1 years vs. 52.2). One-year survival was similar in all groups. Conclusion HEV serology is not commonly tested. Among those tested, seropositivity is uncommon. Our data show higher HEV seropositivity in older adults, which may represent increase risk of exposure over time. Higher percentage of positive testing was also observed in subjects with liver disease, which may indicate a possible etiologic association. Further population-based studies are needed to estimate prevalence of HEV infection and associated liver disease, outcomes in infected patients, and indications for testing in at-risk populations. Disclosures All authors: No reported disclosures.

Hepatitis E virus

2011 ◽  
Author(s):  
X. J. Meng
Keyword(s):  
Hepatitis E Virus ◽  
Animal Species ◽  
Rna Virus ◽  
Hepatitis E ◽  
Open Reading Frames ◽  
Industrialized Countries ◽  
Efficient Cell Culture System ◽  
The Family ◽  
Avian Hev ◽  
Animal Strains

Hepatitis E virus (HEV) is a small, non-enveloped, single-strand, positive-sense RNA virus of approximately 7.2 kb in size. HEV is classified in the family Hepeviridae consisting of four recognized major genotypes that infect humans and other animals. Genotypes 1 and 2 HEV are restricted to humans and often associated with large outbreaks and epidemics in developing countries with poor sanitation conditions, whereas genotypes 3 and 4 HEV infect humans, pigs and other animal species and are responsible for sporadic cases of hepatitis E in both developing and industrialized countries. The avian HEV associated with Hepatitis-Splenomegaly syndrome in chickens is genetically and antigenically related to mammalian HEV, and likely represents a new genus in the family. There exist three open reading frames in HEV genome: ORF1 encodes non-structural proteins, ORF2 encodes the capsid protein, and the ORF3 encodes a small phosphoprotein. ORF2 and ORF3 are translated from a single bicistronic mRNA, and overlap each other but neither overlaps ORF1. Due to the lack of an efficient cell culture system and a practical animal model for HEV, the mechanisms of HEV replication and pathogenesis are poorly understood. The recent identification and characterization of animal strains of HEV from pigs and chickens and the demonstrated ability of cross-species infection by these animal strains raise potential public health concerns for zoonotic HEV transmission. It has been shown that the genotypes 3 and 4 HEV strains from pigs can infect humans, and vice versa. Accumulating evidence indicated that hepatitis E is a zoonotic disease, and swine and perhaps other animal species are reservoirs for HEV. A vaccine against HEV is not yet available.

Evidence for widespread infection of wild rats with hepatitis E virus in the United States.

1999 ◽  
Vol 61 (2) ◽  
pp. 331-335 ◽  
Author(s):  
Y Kabrane-Lazizi ◽  
G E Glass ◽  
H Higa ◽  
A Diwan ◽  
C J Gibbs ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
The United States ◽  
Wild Rats

scholarly journals Prevalence of Antibody to Hepatitis E Virus among Rodents in the United States

2000 ◽  
Vol 181 (2) ◽  
pp. 449-455 ◽  
Author(s):  
Michael O. Favorov ◽  
Michael Y. Kosoy ◽  
Sergei A. Tsarev ◽  
James E. Childs ◽  
Harold S. Margolis
Keyword(s):  
United States ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
The United States

Seroprevalence of hepatitis E antibodies and risk profile of HEV seropositivity in The Netherlands, 2006–2007

2012 ◽  
Vol 140 (10) ◽  
pp. 1838-1847 ◽  
Author(s):  
L. VERHOEF ◽  
M. KOOPMANS ◽  
E. DUIZER ◽  
J. BAKKER ◽  
J. REIMERINK ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Chronic Hepatitis ◽  
The Netherlands ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Risk Profile ◽  
Older Age ◽  
Industrialized Countries ◽  
Vulnerable People ◽  
Independent Association

SUMMARYHepatitis E virus (HEV) is now considered an endemic pathogen in industrialized countries, leading to acute and sometimes chronic hepatitis, mostly in vulnerable people. The endemic sources are unclear. A survey in The Netherlands in 2006–2007 showed a 1·9% seroprevalence of HEV antibodies measured by ELISA and confirmed by immunoblot in a nationwide sample. Overall, in 134/7072 (1·9%) seropositive individuals, older age (P<0·01), being male (P<0·01), working with patients (P=0·03), working with animals (P=0·07), recent diarrhoeal complaints (P=0·07) and adhering to a religion that considers pigs unclean (P<0·01) were independently associated with seropositivity in multivariate analysis. Sub-analysis of 59/4022 (1·5%) anti-HEV antibody-positive subjects with probable endemic exposure showed independent association with youngest household member being aged <5 years or between 19 and <65 years (P=0·05) in multivariate analysis. These findings may contribute to a better understanding of the sources of endemic HEV exposure, and also highlight the need for systematic epidemiological and serological evaluation of new cases.

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