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Transmission, diagnosis, and management of hepatitis E: an update

Authors Mirazo S, Ramos N, Mainardi V, Gerona S, Arbiza J

Received 3 March 2014

Accepted for publication 26 March 2014

Published 3 June 2014 Volume 2014:6 Pages 45—59

DOI https://doi.org/10.2147/HMER.S63417

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Santiago Mirazo,1 Natalia Ramos,1 Victoria Mainardi,2 Solange Gerona,2 Juan Arbiza1

1Laboratory of Virology, Faculty of Sciences, University of the Republic, Montevideo, Uruguay; 2Hepatic Diseases Unit, Central Hospital of the Armed Forces, Montevideo, Uruguay


Abstract: Hepatitis E virus (HEV) infection is an important public health concern in many developing countries, causing waterborne outbreaks as well as sporadic autochthonous hepatitis. HEV is mainly transmitted by the fecal–oral route in endemic areas through drinking of contaminated water. However, zoonotic transmission from animal reservoirs to humans has also been suggested. Three additional routes of HEV transmission have been proposed to occur: blood borne, human to human, and vertical transmission from mother to child. Acute HEV infection is usually diagnosed by detecting specific anti-HEV antibodies. However, the performance of the available assays in different settings is not optimal. Analysis of HEV ribonucleic acid in biologic specimens such as stools, serum, and liver biopsy by using nucleic acid amplification techniques is also employed. Nonetheless, additional consensus regarding the best technologies suitable for serosurveys and diagnosis of acute HEV infection is also needed. This review article summarizes the current status of HEV infection end epidemiology with particular emphasis in transmission, diagnosis, and clinical management.

Keywords: HEV, epidemiology, clinical features, routes of infection


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