Hepatitis E (patient information)
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Hepatitis E |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.B.B.S; João André Alves Silva, M.D. [2]
Overview
Hepatitis E is a liver disease caused by the hepatitis E virus. The hepatitis E virus is transmitted mainly through contaminated drinking water. It is usually a self-limiting infection and resolves within 4–6 weeks. Occasionally, a fulminant form of hepatitis develops (acute liver failure), which can lead to death.
What are the symptoms?
The incidence of hepatitis E is highest in adults between the ages of 15 and 40. Though children often contract this infection as well, they less frequently become symptomatic. Mortality rates are generally low, for Hepatitis E is a “self-limiting” disease, in that it usually goes away by itself and the patient recovers. However, during the duration of the infection (usually several weeks), the disease severely impairs a person’s ability to work, care for family members, and obtain food. Hepatitis E occasionally develops into an acute severe liver disease, and is fatal in about 2% of all cases. Clinically, it is comparable to hepatitis A, but in pregnant women the disease is more often severe and is associated with a clinical syndrome called as 'fulminant hepatic failure'. Pregnant women, especially those in the third trimester, suffer an elevated mortality rate from the disease ~20%.
- Jaundice
- Malaise
- Anorexia
- Nausea
- Vomiting
- Abdominal pain
- Fever
- Hepatomegaly
- Other less common features include diarrhea, arthralgia, pruritus, and urticarial rash. Some patients have asymptomatic infection.
Diagnosis
The following tests are done to identify and monitor liver damage from hepatitis B:
- Albumin level
- Liver function tests
- Prothrombin time
- Antibody test
Transmission
The hepatitis E virus is transmitted mainly through the fecal-oral route due to fecal contamination of drinking water.
Other transmission routes have been identified, including:
- Foodborne transmission from ingestion of products derived from infected animals
- Transfusion of infected blood products
- Vertical transmission from a pregnant woman to her fetus
- Ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.
Although humans are considered the natural host for the hepatitis E virus, antibodies to the hepatitis E virus or closely related viruses have been detected in primates and several other animal species.
Hepatitis E is a waterborne disease, and contaminated water or food supplies have been implicated in major outbreaks.
The risk factors for hepatitis E are related to poor sanitation in large areas of the world and shedding of the hepatitis E virus in faeces.
Treatment options
Hepatitis E usually resolves on its own over several weeks to months.
Possible Complications
Chronic hepatitis, Liver failure
What to expect (Outlook/Prognosis)?
Prognosis mostly is good with only few patients developing chronic hepatitis
Prevention
Improving sanitation is the most important measure, which consists in proper treatment and disposal of human waste, higher standards for public water supplies, improved personal hygiene procedures and sanitary food preparation. Thus, prevention strategies of this disease are similar to those of many others that plague developing nations, and they require large-scale international financing of water supply and water treatment projects. A vaccine based on recombinant viral proteins has been developed
Diseases with similar symptoms
Sources
http://digestive.niddk.nih.gov/ddiseases/pubs/viralhepatitis/#hepe World Health organization