[Hepatitis E virus: an emerging disease].
Hepatitis E virus (HEV) is a spherical, non-enveloped, single stranded RNA virus. Four genotypes (1-4) have so far been distinguished. HEV infection can occur either in large epidemics (in endemic regions only: southeast Asia, India, central Asia central, Africa, and Mexico) or in sporadic forms. HEV is transmitted principally by the fecal-oral pathway, that is, hand-to-mouth. There is a risk of transmission from animals to humans. Nearly half of all cases have no or few symptoms. Symptomatic forms can be severe. The mortality rate can reach 20% in pregnant women. Recent reports indicate that autochthonous cases have been contracted in France. Several aspects differentiate sporadic autochthonous hepatitis from that contracted in endemic areas: 1) mean age of onset is older in the former; 2) prognosis is more severe; and 3) prolonged even chronic forms can affect some immunocompromised patients, in particular, those with organ transplants. The diagnosis of hepatitis E must now be considered in any cases of acute hepatitis of unexplained origin in France. Diagnosis relies on RT-PCR testing of blood or stool.
Péron
Jean-Marie
JM
Service d'Hépato-gastro-entérologie, Fédération digestive, Hôpital Purpan, CHU Toulouse. Peron.jm@chu-toulouse.fr
Mansuy
Jean-Michel
JM
Izopet
Jacques
J
Vinel
Jean-Pierre
JP
D000328:Adult; D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D000818:Animals; D001208:Asia / Q000453:epidemiology; D002648:Child; D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D004196:Disease Outbreaks; D019353:Endemic Diseases; D005602:France / Q000453:epidemiology; D016751:Hepatitis E / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D016752:Hepatitis E virus / Q000145:classification; D006801:Humans; D016867:Immunocompromised Host; D008800:Mexico / Q000453:epidemiology; D016377:Organ Transplantation; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D015047:Zoonoses