Hepatitis E

Virology And Epidemiology

Single-stranded RNA virus.
Features nonenveloped sphere shape with spikes; structurally mimics caliciviruses.
Transmitted predominantly via fecal-oral route; frequently waterborne in endemic areas,.
Zoonotic transmission identified; pigs act as known carriers.
Genotypes 1 and 2 circulate in endemic developing nations.
Genotype 3 associates with undercooked pork consumption in Western countries.
Vertical transmission occurs from infected pregnant women to infants.
Incubation period averages 40 days (range 15-60 days).

Primarily short, self-limited acute illness.
Clinical features mimic hepatitis A but often present more severely.
Exhibits jaundice, malaise, anorexia, fever, abdominal pain, arthralgias.
Peak incidence targets older adolescents and young adults (15-34 years).
Acts as cytopathic virus causing hepatocellular injury.
Acute liver failure risk markedly elevated in pregnant women; mortality approaches 25%,.
Chronic infection absent in immunocompetent individuals.
Chronic cirrhosis/hepatitis develops exclusively in immunosuppressed hosts, including organ transplant recipients,.

Anti-HEV IgM detects acute infection; turns positive approximately 1 week into clinical illness.
Anti-HEV IgG differentiates resolved past infection.
HEV RNA detectable in serum and stool utilizing polymerase chain reaction (PCR),.

Therapy strictly supportive for acute, uncomplicated disease.
Ribavirin indicated specifically for chronic HEV infection manifesting in immunocompromised hosts.
Standard pooled immunoglobulin preparations lack proven preventive efficacy.
Recombinant hepatitis E vaccine highly effective in adults; lacks widespread commercial availability,.