Hepatitis E - Complications of chronic liver disease

Hepatitis E

Definition

Hepatitis E virus (HEV) is a member of the group of hepatotrophic viruses, which cause hepatitis.

Incidence/prevalence

Epidemics of tens of thousands of cases in developing world.

Geography

Cause of water-borne epidemics in the Indian subcontinent and North Africa.

Aetiology/pathophysiology

HEV is an ssRNA virus of the calicivirus group. Hepatitis E, like hepatitis A, is transmitted via the faecal–oral route and has an incubation period of 2–9 weeks. It causes a selflimiting acute hepatitis, with no chronic or carrier state.

Clinical features

HEV causes acute hepatitis, with a prodromal phase of a ‘flulike’ illness, followed by jaundice. Generally there is a 1% risk of fulminant liver failure, except in women in the last trimester of pregnancy where there is a 25% risk.

Management

Supportive care may be required.