A Review of the Diagnosis and Management of Hepatitis E
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Hepatitis C (J Raybould, Section Editor)
A Review of the Diagnosis and Management of Hepatitis E P. Kar1,* R. Karna2 Address *,1 Department of Gastroenterology and Hepatology, Max Super Specialty Hospital,Ghaziabad, Delhi, New Delhi, 110017, India Email: [email protected] 2 Maulana Azad Medical College & Lok Nayak Hospital, Bahadurshah Zafar Road, New Delhi, India
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Hepatitis C Keywords Hepatitis E virus I Ribavirin I Pregnancy I Viral hepatitis
Abstract Purpose of review We aim to provide the readers an up-to-date knowledge of the structure, epidemiology, and transmission followed by a detailed discussion on testing, diagnostics and management of hepatitis E virus infection. We have also included a comprehensive review of hepatitis E in pregnancy. Recent findings European Association for the Study of the Liver established clinical practice guidelines for testing and treatment of suspected hepatitis E virus infections in 2018. Evidence suggests chronic hepatitis E may follow a course similar to hepatitis B/C with progression to cirrhosis and possibly hepatocellular carcinoma in immunocompromised patients. Summary Hepatitis E virus is the most common cause of acute viral hepatitis worldwide. A combination of serology and nucleic acid amplification testing is the recommended strategy for suspected patients. Ribavirin therapy for a period of 3 months is the drug of choice for severe acute hepatitis, acute-on chronic liver failure, and chronic infections from hepatitis E virus in immunocompromised patients who are unresponsive to decreased immunosuppression. PEGylated interferon Ī± can be used for ribavirin-resistant liver transplant patients with chronic hepatitis E. Further research in therapeutic options is essential considering the stormy course of hepatitis E infection during pregnancy and teratogenicity of all available options.
Introduction Hepatitis E virus (HEV) causes acute hepatitis and acute liver failure (ALF) and is the most common
cause of acute viral hepatitis worldwide. It was discovered in the early 1980s when sera of patients
Hepatitis C (J Raybould, Section Editor) suspected of viral hepatitis during an outbreak in Kashmir province of India tested negative for hepatitis A and B [1, 2]. This enterically transmitted non-A non-B hepatitis virus was termed as hepatitis E virus, with āEā standing for its association with epidemics and enteric mode of transmission. The article aims to provide the readers with up-to-date knowledge and recent advances in the clinical aspects of hepatitis E virus infection focusing mainly on diagnostics and management options.
Structure of HEV HEV is a member of the Orthohepevirus genus and belongs to the Hepeviridae family. It is a small, non-enveloped 27ā34-nm diameter particle with an icosahedral capsid. The virus was first isolated in the 1980s, from stool suspension of HEVinfected patients, and the excreted form of HEV in stool was found to
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