hepatic and biliary disorders
Hepatitis E
Introduction
Hepatitis E is caused by an enterically transmitted RNA virus and causes typical symptoms of viral hepatitis, including anorexia, malaise, and jaundice. Fulminant hepatitis and death are rare, except during pregnancy. Diagnosis is by antibody testing. Treatment is supportive unless chronic infection develops. (See also Causes of Hepatitis and There are 4 genotypes of hepatitis E virus (HEV). All can cause acute viral hepatitis. usually cause waterborne outbreaks that are linked to fecal contamination of the water supply and fecal-oral person-to-person transmission. Outbreaks have occurred in China, India, Mexico, Pakistan, Peru, Russia, and central and northern Africa. These outbreaks have epidemiologic characteristics similar to those associated with Hepatitis A epidemics. Sporadic cases also occur. No outbreaks have occurred in the US or in Western Europe. Most cases in the areas with adequate and effective sanitation facilities occur in travelers returning from an area without such sanitation facilities, but sporadic cases not associated with travel have been reported. Genotypes 3 and 4typically cause sporadic cases rather than outbreaks. Transmission is food-borne and can involve eating uncooked or undercooked meat; cases have been associated with consumption of pork, deer, and shellfish. HEV was not originally thought to cause Overview of Chronic Hepatitis , cirrhosis, or chronic carrier state; however, reports document chronic genotype 3 hepatitis E exclusively in immunocompromised patients (including organ-transplant recipients, patients receiving cancer chemotherapy, and HIV-infected patients). 