Hepatitis E is endemic in many developing countries where it causes substantial morbidity. In industrialised countries, it is considered rare, and largely confined to travellers returning from endemic areas. However, there is now a growing body of evidence that challenges this notion. Autochthonous hepatitis E in developed countries is far more common than previously recognised, and might be more common than hepatitis A. Hepatitis E has a predilection for older men in whom it causes substantial morbidity and mortality. The disease has a poor prognosis in the context of pre-existing chronic liver disease, and is frequently misdiagnosed as drug-induced liver injury. The source and route of infection remain uncertain, but it might be a porcine zoonosis. Patients with unexplained hepatitis should be tested for hepatitis E, whatever their age or travel history.

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(08)70255-X.pdf

Hepatitis E: an emerging infection in developed countries

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)61030-6.pdf

Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large-scale, randomised, double-blind placebo-controlled, phase 3 trial

https://www.gastrojournal.org/article/0016-5085(83)90336-0/pdf

Non-A, non-B hepatitis. I. Recognition, epidemiology, and clinical features

Hepatitis E virus (HEV) infection causes severe liver disease in pregnant women. In a case series of 220 pregnant women with jaundice and acute viral hepatitis, women with HEV infection died more o...

/pdf/maternal-and-fetal-outcomes-in-pregnant-women-with-acute-3dkx20n5ud.pdf

Mohammad Amin Sofi

Papers

Incidence and severity of viral hepatitis in pregnancy.