Hepatitis E: an emerging infection in developed countries.
Hepatitis E is endemic in many developing countries where it causes substantial morbidity. In industrialised countries, it is considered rare, and largely confined to travellers returning from endemic areas. However, there is now a growing body of evidence that challenges this notion. Autochthonous hepatitis E in developed countries is far more common than previously recognised, and might be more common than hepatitis A. Hepatitis E has a predilection for older men in whom it causes substantial morbidity and mortality. The disease has a poor prognosis in the context of pre-existing chronic liver disease, and is frequently misdiagnosed as drug-induced liver injury. The source and route of infection remain uncertain, but it might be a porcine zoonosis. Patients with unexplained hepatitis should be tested for hepatitis E, whatever their age or travel history.
Dalton
Harry R
HR
Peninsula College of Medicine and Dentistry, Royal Cornwall Hospital Trust, Truro, UK. harry.dalton@rcht.cornwall.nhs.uk
Bendall
Richard
R
Ijaz
Samreen
S
Banks
Malcolm
M
D000818:Animals; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D019049:Developed Countries; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016752:Hepatitis E virus / Q000145:classification; D006801:Humans; D015994:Incidence; D016036:Seroepidemiologic Studies; D015047:Zoonoses / Q000635:transmission