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BioMed Research International
Volume 2016 (2016), Article ID 9838041, 17 pages
Review Article

Hepatitis E Virus in Industrialized Countries: The Silent Threat

1Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha, 02008 Albacete, Spain
2School of Pharmacy, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
3School of Medicine, Universidad de Castilla-La Mancha, 02008 Albacete, Spain

Received 6 September 2016; Revised 7 November 2016; Accepted 15 November 2016

Academic Editor: Yanjin Zhang

Copyright © 2016 Pilar Clemente-Casares et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide. Its presence in developing countries has been documented for decades. Developed countries were supposed to be virus-free and initially only imported cases were detected in those areas. However, sporadic and autochthonous cases of HEV infection have been identified and studies reveal that the virus is worldwide spread. Chronic hepatitis and multiple extrahepatic manifestations have also been associated with HEV. We review the data from European countries, where human, animal, and environmental data have been collected since the 90s. In Europe, autochthonous HEV strains were first detected in the late 90s and early 2000s. Since then, serological data have shown that the virus infects quite frequently the European population and that some species, such as pigs, wild boars, and deer, are reservoirs. HEV strains can be isolated from environmental samples and reach the food chain, as shown by the detection of the virus in mussels and in contaminated pork products as sausages or meat. All these data highlight the need of studies directed to control the sources of HEV to protect immunocompromised individuals that seem the weakest link of the HEV epidemiology in industrialized regions.