title: Hepatitis E virus: An ancient hidden enemy in Latin America.
abstract: Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide. HEV is an RNA-containing virus and the only member of the genus Hepevirus in the family Hepeviridae. Human HEV is classified into four genotypes widely distributed across the world. The virus is mainly transmitted via the fecal-oral route, and water-borne epidemics have become characteristic of hepatitis E in developing countries, including those in Latin America. The zoonotic potential of HEV is broadly recognized. Thus, there is an urgent need to re-evaluate virus transmission scenarios and to enforce epidemiological surveillance systems. Additionally, it is known that HEV infections, initially defined as self-limiting, can also take chronic courses in immunocompromised patients. Moreover, we recently reported a high seroprevalence of HEV in samples from cirrhotic patients with no other etiological agents present, suggesting the potential role of HEV in the development of chronic liver illness. In this review, HEV genomic variability, transmission, chronic infectious course, zoonotic potential and treatment are discussed. Focus is placed on the impact of HEV infection in Latin America, to support the development of specific control strategies and the handling of this important and typically imperceptible viral infection.
authors.affiliation: Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México.
authors.forename: Nora A
authors.initials: NA
authors.lastname: Fierro
authors.affiliation: Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Realpe
authors.affiliation: Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México.
authors.forename: Tzintli
authors.initials: T
authors.lastname: Meraz-Medina
authors.affiliation: Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México.
authors.forename: Sonia
authors.initials: S
authors.lastname: Roman
authors.affiliation: Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México.
authors.forename: Arturo
authors.initials: A
authors.lastname: Panduro
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D014644:Genetic Variation; D005838:Genotype; D016751:Hepatitis E / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D016752:Hepatitis E virus / Q000235:genetics / Q000472:pathogenicity*; D006521:Hepatitis, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome; D015047:Zoonoses
chemical_list: D000998:Antiviral Agents
keywords: Emerging diseases; Hepatitis E virus-chronic infection; Mexico; Viral genotypes; Zoonosis