Hepatitis E virus

Hepatitis E presents with the typical clinical and morphologic features of acute hepatitis. Discovered in 1990, hepatitis E virus (HEV) is now recognised as the agent responsible for nearly all enterically transmitted non-A, non-B hepatitis. Hepatitis E is principally the result of water borne infection and while large-scale outbreaks have been reported in several developing countries, sporadic cases can occur in developed countries where the seroprevalence is around 1%. Acute hepatitis E infection, like hepatitis A, is an acute, self-limiting infection that may vary in severity from subclinical (more likely in children) to fulminant hepatitis. The incubation period is approximately 40 days (range 15-60 days). The death rate of patients infected with HEV is <1%, however, the mortality from HEV in pregnant patients is high (around 20%) for reasons which remain unclear. The diagnosis of acute hepatitis E relies on serology and molecular testing for HEV RNA.