The Clinical Perspective on Hepatitis E
Every year, there are an estimated 20 million hepatitis E virus (HEV) infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E. HEV is largely circulating in the west and is associated with several hepatic and extrahepatic diseases. HEV Genotype 1 and 2 infections a...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-07-01
|
| Series: | Viruses |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-4915/11/7/617 |
| _version_ | 1819265805701873664 |
|---|---|
| author | Thomas Horvatits Julian Schulze zur Wiesch Marc Lütgehetmann Ansgar W. Lohse Sven Pischke |
| author_facet | Thomas Horvatits Julian Schulze zur Wiesch Marc Lütgehetmann Ansgar W. Lohse Sven Pischke |
| author_sort | Thomas Horvatits |
| collection | DOAJ |
| description | Every year, there are an estimated 20 million hepatitis E virus (HEV) infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E. HEV is largely circulating in the west and is associated with several hepatic and extrahepatic diseases. HEV Genotype 1 and 2 infections are waterborne and causative for epidemics in the tropics, while genotype 3 and 4 infections are zoonotic diseases and are mainly transmitted by ingestion of undercooked pork in industrialized nations. The clinical course of these infections differs: genotype 1 and 2 infection can cause acute illness and can lead to acute liver failure (ALF) or acute on chronic liver failure (ACLF) with a high mortality rate of 20% in pregnant women. In contrast, the majority of HEV GT-3 and -4 infections have a clinically asymptomatic course and only rarely lead to acute on chronic liver failure in elderly or patients with underlying liver disease. Immunosuppressed individuals infected with genotype 3 or 4 may develop chronic hepatitis E, which then can lead to life-threatening cirrhosis. Furthermore, several extra-hepatic manifestations affecting various organs have been associated with ongoing or previous HEV infections but the causal link for many of them still needs to be proven. There is no approved specific therapy for the treatment of acute or chronic HEV GT-3 or -4 infections but off-label use of ribavirin has been demonstrated to be safe and effective in the majority of patients. However, in approximately 15% of chronically HEV infected patients, cure is not possible. |
| first_indexed | 2024-12-23T20:51:13Z |
| format | Article |
| id | doaj.art-c376ec974a844db2a48953ba8ee8a9ad |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-12-23T20:51:13Z |
| publishDate | 2019-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-c376ec974a844db2a48953ba8ee8a9ad2022-12-21T17:31:40ZengMDPI AGViruses1999-49152019-07-0111761710.3390/v11070617v11070617The Clinical Perspective on Hepatitis EThomas Horvatits0Julian Schulze zur Wiesch1Marc Lütgehetmann2Ansgar W. Lohse3Sven Pischke4Department of Medicine, University Medical Center Hamburg-Eppendorf, 22527 Hamburg, GermanyDepartment of Medicine, University Medical Center Hamburg-Eppendorf, 22527 Hamburg, GermanyGerman Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 22527 Hamburg, GermanyDepartment of Medicine, University Medical Center Hamburg-Eppendorf, 22527 Hamburg, GermanyDepartment of Medicine, University Medical Center Hamburg-Eppendorf, 22527 Hamburg, GermanyEvery year, there are an estimated 20 million hepatitis E virus (HEV) infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E. HEV is largely circulating in the west and is associated with several hepatic and extrahepatic diseases. HEV Genotype 1 and 2 infections are waterborne and causative for epidemics in the tropics, while genotype 3 and 4 infections are zoonotic diseases and are mainly transmitted by ingestion of undercooked pork in industrialized nations. The clinical course of these infections differs: genotype 1 and 2 infection can cause acute illness and can lead to acute liver failure (ALF) or acute on chronic liver failure (ACLF) with a high mortality rate of 20% in pregnant women. In contrast, the majority of HEV GT-3 and -4 infections have a clinically asymptomatic course and only rarely lead to acute on chronic liver failure in elderly or patients with underlying liver disease. Immunosuppressed individuals infected with genotype 3 or 4 may develop chronic hepatitis E, which then can lead to life-threatening cirrhosis. Furthermore, several extra-hepatic manifestations affecting various organs have been associated with ongoing or previous HEV infections but the causal link for many of them still needs to be proven. There is no approved specific therapy for the treatment of acute or chronic HEV GT-3 or -4 infections but off-label use of ribavirin has been demonstrated to be safe and effective in the majority of patients. However, in approximately 15% of chronically HEV infected patients, cure is not possible.https://www.mdpi.com/1999-4915/11/7/617Hepatitis EHEV |
| spellingShingle | Thomas Horvatits Julian Schulze zur Wiesch Marc Lütgehetmann Ansgar W. Lohse Sven Pischke The Clinical Perspective on Hepatitis E Viruses Hepatitis E HEV |
| title | The Clinical Perspective on Hepatitis E |
| title_full | The Clinical Perspective on Hepatitis E |
| title_fullStr | The Clinical Perspective on Hepatitis E |
| title_full_unstemmed | The Clinical Perspective on Hepatitis E |
| title_short | The Clinical Perspective on Hepatitis E |
| title_sort | clinical perspective on hepatitis e |
| topic | Hepatitis E HEV |
| url | https://www.mdpi.com/1999-4915/11/7/617 |
| work_keys_str_mv | AT thomashorvatits theclinicalperspectiveonhepatitise AT julianschulzezurwiesch theclinicalperspectiveonhepatitise AT marclutgehetmann theclinicalperspectiveonhepatitise AT ansgarwlohse theclinicalperspectiveonhepatitise AT svenpischke theclinicalperspectiveonhepatitise AT thomashorvatits clinicalperspectiveonhepatitise AT julianschulzezurwiesch clinicalperspectiveonhepatitise AT marclutgehetmann clinicalperspectiveonhepatitise AT ansgarwlohse clinicalperspectiveonhepatitise AT svenpischke clinicalperspectiveonhepatitise |