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Hepatitis E

Dr. Rajalakshmi VK (AIIMS)MBBS

October 23, 2020

October 23, 2020

Hepatitis E
Hepatitis E

Hepatitis E is an acute condition that targets the liver (an acute condition is one that can occur suddenly or severely, and which does not usually result in prolonged illness). Even though anyone, anywhere in the world can get hepatitis E, it is more commonly seen in developing countries.

The infection, caused by the hepatitis E virus (HEV), is one of five types of viral hepatitis—hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E. While hepatitis B and hepatitis C can cause chronic or long-time illness, hepatitis E usually doesn't extend beyond six weeks.

(In October 2020, the Royal Swedish Academy of Sciences awarded the 2020 Nobel Prize for Medicine to Harvey J. Alter, Michael Houghton and Charles M. Rice, who discovered hepatitis C, a much more lethal infection than hepatitis A, D or E).

Most people with hepatitis E recover completely, as the condition does not cause long term damage to the liver in most cases. Anyone with a weak immune system, including pregnant women, are more prone to facing complications. In 2015, the World Health Organization (WHO) estimated that hepatitis E accounted for 3.3% of the mortality due to viral hepatitis.

Continue reading to find out more about the causes, symptoms and treatments available for hepatitis E.

Symptoms of Hepatitis E

The symptoms of hepatitis E show up two to six weeks after contracting the infection. However, it is also possible to have this infection and be asymptomatic. Some of the common symptoms of the condition are as follows:

Causes of hepatitis E

The most common cause of hepatitis E is the consumption of food or water contaminated with the faecal matter of an infected person. Poor sanitation such as sewage mixing with drinking water and not washing hands can further transmit the virus.

Other routes of infection have also been identified. These include blood transfusions or by eating products from infected animals, especially undercooked meat. Vertical transmission from a pregnant mother to the baby is also possible. These, however, are less commonly found.

Diagnosis of hepatitis E

Hepatitis E and its symptoms are clinically very similar to other forms of viral hepatitis, making it hard to distinguish and diagnose. The doctor will ask about your symptoms and medical history, including if you have travelled anywhere recently.

A definitive diagnosis can be made through a hepatitis E test, which is a blood test. Rapid tests for the same are also available. Additionally, RT-PCR test can be used to detect the presence of viral RNA in the body.

Treatment of Hepatitis E

Hepatitis E usually resolves on its own within four to six weeks. There is no specific course of treatment that can alter how the disease progresses.

Hospitalization is not necessary, except in acute (severe) cases where a 21-day course of ribavirin may be prescribed.

Where the virus is self-limiting, recovery tends to be fast. Doctors advise taking rest and drink lots of fluids. It is important to avoid any unnecessary medication, even acetaminophen or paracetamol. One should also steer clear of alcohol, while they are sick.

Hepatitis E outcome or prognosis

The prognosis is usually good as hepatitis E typically causes short-term infections that the body can overcome. The mortality rate of the condition is 1%.  However, this acute condition can also become chronic, especially in pregnant women and those with a suppressed immune system (immunocompromised). Consulting a healthcare profession and self-care is often enough to recover from hepatitis E.



References

  1. Harsh Kumar, Nassim Kamar, Gheyath K. Nasrallah, Dinesh Kumar, Hepatitis E Viruses,Emerging and Transboundary Animal Viruses 10.1007/978-981-15-0402-0_15, (357-377), (2020).
  2. Ming-Hui Liao, Fang-Tzy Wu, Huimin Bai, Yen Hai Doan, Jyh-Yuan Yang, Naokazu Takeda, Masamichi Muramatsu, Tian-Cheng Li Hepatitis E virus infection in 6-month-old pigs in Taiwan, Scientific Reports, 10.1038/s41598-020-74034-8
  3. Nassim Kamar, Richard Bendall, Florence Legrand-Abravanel, Ning-Shao Xia, Samreen Ijaz, Jacques Izopet, Harry R Dalton, Hepatitis E The Lancet, Volume 379, Issue 9835, 2012, Pages 2477-2488,
  4. M.S. Khuroo, S. Kamali, S. Jameel, Vertical transmission of hepatitis E virus , The Lancet, Volume 345, Issue 8956, 1995, Pages 1025-1026

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