title: Mystery of hepatitis e virus: recent advances in its diagnosis and management.
abstract: Mysterious aspects of the long presumed to be well-known hepatitis E virus (HEV) have recently surfaced that distinguish it from other hepatotropic viruses. It is a cause of chronic hepatitis in immunosuppressed patients. It has human to human transmission through blood and mantains high seroprevalence in blood donors. HEV has also been found to occur more frequently in the West in those without a history of travel to endemic countries. It has varied extrahepatic manifestations and has multiple non-human reservoirs including pigs and rats. Considering these recent discoveries, it appears odd that HEV is not sought more frequently when working up acute and chronic hepatitis patients. The disease is particularly severe among pregnant women and has a high attack rate in young adults. What adds to its ambiguity is the absence of a well-established diagnostic criteria for its detection and that there is no specific antiviral drug for hepatitis E, except for isolated cases where ribavirin or pegylated interferon alpha has been used with occasional success. This review paper discusses the recent advances in the knowledge of the virus itself, its epidemiology, diagnostic approach and prevention, and the treatment options available.
authors.affiliation: Department of Internal Medicine, Oklahoma University Health Sciences Center, Williams Pavilion 1130, P.O. Box 26901, Oklahoma City, OK 73104, USA.
authors.forename: Aftab
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Internal Medicine, Oklahoma University Health Sciences Center, Williams Pavilion 1130, P.O. Box 26901, Oklahoma City, OK 73104, USA.
authors.forename: Ijlal Akbar
authors.initials: IA
authors.lastname: Ali
authors.affiliation: Dow Medical College, Mission Road, Karachi 74200, Pakistan.
authors.forename: Hira
authors.initials: H
authors.lastname: Ghazal
authors.affiliation: Section of Digestive Diseases and Nutrition, Oklahoma University Health Sciences Center, Williams Pavilion 1345, 920 SL Young Boulevard, Oklahoma City, OK 73104, USA.
authors.forename: Javid
authors.initials: J
authors.lastname: Fazili
authors.affiliation: Section of Digestive Diseases and Nutrition, Oklahoma University Health Sciences Center, Williams Pavilion 1345, 920 SL Young Boulevard, Oklahoma City, OK 73104, USA.
authors.forename: Salman
authors.initials: S
authors.lastname: Nusrat