Tijdschrift voor geneeskunde vol:64 issue:9 pages:467-470
Hepatitis E virus (HEV) is a frequent cause of acute hepatitis in central an southeast Asia, the Middle East, parts of Africa an Mexico. Its incidence in the US and Europe appears to be very low with most of the sporadic cases linked to a history of traveling to endemic areas.
The major mode of transmission is faeco-oral via faecally contaminated drinking water. Acute HEV infection can present as an anicteric or icteric hepatitis. Fulminant hepatic failure is uncommon, except among pregnant women in whom the illness may be particularly severe. Evolution to chronic hepatitis E infection, cirrhosis or hepatocellular carcinoma has so far not been observed.
An HEV infection is diagnosed by identification of HEV IgM and IgG antibodies. No specific treatment is available. Encouraging advances have been made in HEV vaccine development. Recent findings have disclosed the possibility of a zoonotic HEV infection, even in the western world, with swine as animal reservoir.