title: [Hepatitis E: an emerging disease].
abstract: The hepatitis E virus is endemic in countries with poor sanitation, where it has many similarities with the hepatitis A virus. It causes a strictly human, feco-oral transmitted, acute, self-limited hepatitis in young adults. The outcome is excellent, except in pregnant women and cirrhotic patients, who experience a high mortality rate. The first cases described in industrialized countries were travellers coming from endemic areas. However, there is now growing evidence that locally-acquired hepatitis E is common in these areas, where it is an emergent disease, despite it is still misdiagnosed. In industrialized countries, hepatitis E spreads sporadically and has a predilection for elderly men with comorbidity, particularly chronic liver diseases. The mortality seems to be higher in this population. In these areas, hepatitis E is due to the genotype 3 virus that is thought to be zoonotically transmitted by pigs and wild boar. Hepatitis E may evolve towards a chronic infection in immunocompromised subjects, particularly in solid organ-transplanted patients. In case of chronic infection, it may cause liver fibrosis and cirrhosis. The diagnosis of hepatitis E is based on serological tests (IgM and IgG) and detection of the viral genome by reverse transcription polymerase chain reaction (RT-PCR) on blood and stools. Acute hepatitis E does not require any treatment but in chronically infected patients, a sustained viral response and finally a definitive viral clearance has been observed after a three-month course of low-dose ribavirin (600 to 800 mg/day). Two vaccines underwent successful human trials but are not yet commercially available.
authors.affiliation: Service de médecine interne, fédération digestive, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. bonnet.d@chu-toulouse.fr
authors.forename: D
authors.initials: D
authors.lastname: Bonnet
authors.forename: N
authors.initials: N
authors.lastname: Kamar
authors.forename: J
authors.initials: J
authors.lastname: Izopet
authors.forename: L
authors.initials: L
authors.lastname: Alric
mesh_terms: D000328:Adult; D000368:Aged; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D005260:Female; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D016752:Hepatitis E virus / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D012698:Serologic Tests; D055815:Young Adult