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World J Hepatol. Dec 27, 2011; 3(12): 285-291
Published online Dec 27, 2011. doi: 10.4254/wjh.v3.i12.285
Hepatitis E: Epidemiology and prevention
Eyasu H Teshale, Dale J Hu
Eyasu H Teshale, Dale J Hu, Division of Viral Hepatitis, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, TB Prevention, Atlanta, GA 30333, United States
Author contributions: Teshale EH and Hu DJ contributed equally to the writing of this manuscript.
Correspondence to: Eyasu H Teshale, MD, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, TB Prevention, Division of Viral Hepatitis, 1600 Clifton Rd, NE, MS G-37, Atlanta, GA 30333, United States.
Telephone: +1-404-7188553 Fax: +1-404-7188585
Received: February 28, 2011
Revised: September 15, 2011
Accepted: November 8, 2011
Published online: December 27, 2011

Hepatitis E is caused by the hepatitis E virus (HEV), the major etiologic agent of enterically transmitted non-A hepatitis worldwide. HEV is responsible for major outbreaks of acute hepatitis in developing countries, especially in many parts of Africa and Asia. The HEV is a spherical, non-enveloped, single-stranded, positive sense RNA virus that is approximately 32 nm to 34 nm in diameter and is the only member in the family Hepeviridae and genus Hepevirus. There are four distinct genotypes of HEV (genotypes 1-4). While genotype 1 is predominantly associated with large epidemics in developing countries, genotype 3 has recently emerged as a significant pathogen in developed countries. The clinical manifestations and the laboratory abnormalities of hepatitis E are not distinguishable from that caused by other hepatitis viruses. However, high mortality among pregnant women particularly during the third trimester distinguishes HEV from other causes of acute viral hepatitis. Specific etiologic diagnosis among infected cases can be made by serological testing or detection of viral nucleic acid by reverse transcription polymerase chain reaction. Although there are vaccine candidates that had been shown to be safe and efficacious in clinical trials, none are approved currently for use. There is no specific therapy for acute hepatitis E as treatment remains supportive.

Keywords: Hepatitis E virus, Acute viral hepatitis, Outbreak, Epidemiology, Serology, Prevention