title: Hepatitis E: An Underdiagnosed, Emerging Infection in Nonendemic Regions.
abstract: Although hepatitis E virus (HEV) is the primary cause of enterically transmitted acute hepatitis and jaundice in developing countries, locally acquired HEV infections are increasing in nonendemic countries. As such, HEV is emerging as an underdiagnosed cause of infection. This report describes three clinically variable cases of HEV infection with unusual clinical presentations. These cases highlight the fact that HEV should be considered in the differential diagnosis of patients with unexplained hepatitis (acute or chronic) with or without extrahepatic manifestations. HEV should also be considered in patients with persistently elevated liver enzymes who have not travelled to known HEV-endemic regions. Lack of knowledge among physicians and an absence of standardized diagnostic tests may result in increased morbidity and mortality from HEV infection.
authors.affiliation: Department of Laboratory Medicine, AZ St-Jan Bruges, Bruges, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: De Keukeleire
authors.affiliation: Department of Laboratory Medicine, AZ St-Jan Bruges, Bruges, Belgium.
authors.forename: Marijke
authors.initials: M
authors.lastname: Reynders
keywords: Autochthonous hepatitis E; HEV RNA; Hepatitis E; Polymerase chain reaction; Seroprevalence