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Hepatitis E

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Hepatitis E, Hepatitis E Virus, HEV

  • See Also
  1. Viral Hepatitis
  • Epidemiology
  1. Enteric transmission of non-A, non-B Hepatitis
    1. Most common cause of Acute Viral Hepatitis in world
  2. Regions with Waterborne Illness epidemics (esp. with monsoon flooding)
    1. India
    2. Asia
    3. Africa
    4. Mexico
  • Pathophysiology
  1. Transmission: Fecal-Oral Route (similar to Hepatitis A Virus)
  2. Incubation Period: 15-60 days (mean 40 days)
  3. Infectivity: Virus excretion in stool for <14 days
  4. Calicivirus (diameter 32-34 nm))
  • Course
  1. Self-limited illness
  • Findings
  • Signs and Symptoms
  1. See Viral Hepatitis
  • Differential Diagnosis
  1. See Acute Hepatitis Causes
  • Management
  1. General and symptomatic
    1. High calorie diet (better tolerated in morning)
    2. IV Hydration when indicated for severe Dehydration
    3. Cholestyramine up to 4g PO qid for severe Pruritus
    4. Avoid drugs with hepatic metabolism
  2. Antiviral Agents may be considered (consult infectious disease)
    1. Ribavirin
    2. Interferon-alpha
  • Prognosis
  • Increased Morbidity and Mortality Risks
  1. Pregnant women (mortality 10-20% in some studies)
  2. Extremes of age
  3. Immunocompromised patients
  4. Chronic Liver Disease
  • Complications
  1. Self-limited in most otherwise healthy patients
  2. Chronic hepatitis (rare)
    1. Primarily limited to Immunocompromised patients
    2. Cirrhosis may occur in these patients
  • References
  1. Aslan (2020) World J Gastroenterol 26(37):5543-60 +PMID: 33071523 [PubMed]