title: Hepatitis E Virus Mutations: Functional and Clinical Relevance.
abstract: Hepatitis E virus (HEV) infection is a major cause of acute hepatitis and affects more than 20 million individuals, with three million symptomatic cases and 56,000 recognized HEV-related deaths worldwide. HEV is endemic in developing countries and is gaining importance in developed countries, due to increased number of autochthone cases. Although HEV replication is controlled by the host immune system, viral factors (especially specific viral genotypes and mutants) can modulate HEV replication, infection and pathogenesis. Limited knowledge exists on the contribution of HEV genome variants towards pathogenesis, susceptibility and to therapeutic response. Nonsynonymous substitutions can modulate viral proteins structurally and thus dysregulate virus-host interactions. This review aims to compile knowledge and discuss recent advances on the casual role of HEV heterogeneity and its variants on viral morphogenesis, pathogenesis, clinical outcome and antiviral resistance.
authors.affiliation: Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany. Electronic address: tong.van-hoang@uni-tuebingen.de.
authors.forename: Hoang
authors.initials: H
authors.lastname: van Tong
authors.affiliation: Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
authors.forename: Nghiem Xuan
authors.initials: NX
authors.lastname: Hoan
authors.affiliation: Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
authors.affiliation: Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany. Electronic address: bockc@rki.de.
authors.forename: C-Thomas
authors.initials: CT
authors.lastname: Bock
authors.affiliation: Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
authors.forename: Thirumalaisamy P
authors.initials: TP
authors.lastname: Velavan
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D014644:Genetic Variation; D016679:Genome, Viral; D005838:Genotype; D016751:Hepatitis E / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D016752:Hepatitis E virus / Q000145:classification / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D009154:Mutation; D016366:Open Reading Frames; D012367:RNA, Viral; D011995:Recombination, Genetic; D014765:Viral Vaccines / Q000235:genetics / Q000276:immunology; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D014765:Viral Vaccines
keywords: HEV infection; HEV mutation; HEV replication; HEV treatment failure; HEV variability; Hepatitis E virus