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).
Clinical Manifestations
- 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,.
Diagnostic Evaluation
- 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),.
Management And Prevention
- 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,.
