Hepatitis E virus: Difference between revisions
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== Background == |
== Background == |
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=== Microbiology === |
=== Microbiology === |
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* Refers to viruses in the [[Family::Hepeviridae]] family of RNA viruses |
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** Genus [[Genus::Orthohepevirus]], which infects terrestrial mammals and contains species A-D |
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*** HEV-A is the main human pathogen |
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**** Genotypes 1 and 2 only infect humans |
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**** Genotypes 3 and 4 circulate in pigs but can infect humans |
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*** HEV-C circulates in rodents and ferrets |
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** Genus [[Piscihepevirus]], which infects the cutthroat trout and is not of clinical interest |
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* Four genotypes, g1 through g4 |
* Four genotypes, g1 through g4 |
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=== Epidemiology === |
=== Epidemiology === |
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* Present globally |
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* g1 and g2 are more common in developing countries |
* g1 and g2 are more common in developing countries |
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** Cause epidemic hepatitis |
** Cause epidemic hepatitis |
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** Zoonoses associated with pigs; humans are incidental hosts |
** Zoonoses associated with pigs; humans are incidental hosts |
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** Most severe infections in pregnant women |
** Most severe infections in pregnant women |
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* May also be transmitted by transplant or transfusion |
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== Clinical Manifestations == |
== Clinical Manifestations == |
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** [[Cholestasis]] more common in pregnant women |
** [[Cholestasis]] more common in pregnant women |
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* Liver enzyme abnormalities, over 1000 initially, and [[Causes::hyperbilirubinemia]] |
* Liver enzyme abnormalities, over 1000 initially, and [[Causes::hyperbilirubinemia]] |
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* Usually self-limited, but some patients progress to fulminant hepatitis |
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* In immunocompromised patients, may lead to chronic infection and [[cirrhosis]] |
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* Particularly high mortality rate in pregnant women (25% in third trimester) |
* Particularly high mortality rate in pregnant women (25% in third trimester) |
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Latest revision as of 13:38, 30 August 2022
Background
Microbiology
- Refers to viruses in the Hepeviridae family of RNA viruses
- Genus Orthohepevirus, which infects terrestrial mammals and contains species A-D
- HEV-A is the main human pathogen
- Genotypes 1 and 2 only infect humans
- Genotypes 3 and 4 circulate in pigs but can infect humans
- HEV-C circulates in rodents and ferrets
- HEV-A is the main human pathogen
- Genus Piscihepevirus, which infects the cutthroat trout and is not of clinical interest
- Genus Orthohepevirus, which infects terrestrial mammals and contains species A-D
- Four genotypes, g1 through g4
Epidemiology
- Present globally
- g1 and g2 are more common in developing countries
- Cause epidemic hepatitis
- Transmitted fecal-orally
- Associated with contaminated water and poor sanitation
- g3 and g4 more common in the North America and Europe
- Zoonoses associated with pigs; humans are incidental hosts
- Most severe infections in pregnant women
- May also be transmitted by transplant or transfusion
Clinical Manifestations
- Incubation period of about 4 to 6 weeks
- Flu-like prodrome lasting 1 to 10 days with a low-grade fever, followed by hepatitis
- May develop pale stools, dark urine, and jaundice
- Hepatomegaly and sometimes splenomegaly
- Cholestasis more common in pregnant women
- Liver enzyme abnormalities, over 1000 initially, and hyperbilirubinemia
- Usually self-limited, but some patients progress to fulminant hepatitis
- In immunocompromised patients, may lead to chronic infection and cirrhosis
- Particularly high mortality rate in pregnant women (25% in third trimester)
