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International Journal of Hepatology
Volume 2015 (2015), Article ID 872431, 6 pages
http://dx.doi.org/10.1155/2015/872431
Review Article

Mystery of Hepatitis E Virus: Recent Advances in Its Diagnosis and Management

1Department of Internal Medicine, Oklahoma University Health Sciences Center, Williams Pavilion 1130, P.O. Box 26901, Oklahoma City, OK 73104, USA
2Dow Medical College, Mission Road, Karachi 74200, Pakistan
3Section of Digestive Diseases and Nutrition, Oklahoma University Health Sciences Center, Williams Pavilion 1345, 920 SL Young Boulevard, Oklahoma City, OK 73104, USA

Received 28 September 2014; Accepted 27 December 2014

Academic Editor: Maria Buti

Copyright © 2015 Aftab Ahmed 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.

Abstract

Mysterious aspects of the long presumed to be well-known hepatitis E virus (HEV) have recently surfaced that distinguish it from other hepatotropic viruses. It is a cause of chronic hepatitis in immunosuppressed patients. It has human to human transmission through blood and mantains high seroprevalence in blood donors. HEV has also been found to occur more frequently in the West in those without a history of travel to endemic countries. It has varied extrahepatic manifestations and has multiple non-human reservoirs including pigs and rats. Considering these recent discoveries, it appears odd that HEV is not sought more frequently when working up acute and chronic hepatitis patients. The disease is particularly severe among pregnant women and has a high attack rate in young adults. What adds to its ambiguity is the absence of a well-established diagnostic criteria for its detection and that there is no specific antiviral drug for hepatitis E, except for isolated cases where ribavirin or pegylated interferon alpha has been used with occasional success. This review paper discusses the recent advances in the knowledge of the virus itself, its epidemiology, diagnostic approach and prevention, and the treatment options available.