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Volume 2014 (2014), Article ID 481016, 14 pages
Review Article

Light and Darkness: Prevalence of Hepatitis E Virus Infection among the General Population

Department of Virology, National Centre of Microbiology, Instituto de Salud Carlos III, Road Majadahonda-Pozuelo, Km2, Majadahonda, 28220 Madrid, Spain

Received 7 November 2013; Accepted 25 December 2013; Published 10 February 2014

Academic Editors: S. Bofill-Mas, M. Ciccozzi, M. T. Shata, and F. R. Spilki

Copyright © 2014 José-Manuel Echevarría. 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.


Human hepatitis E virus (HHEV) spreads early in life among the population in areas endemic for genotype 1 and infects mainly adults in areas endemic for genotype 3, where it would be responsible for about 10% of cases of suspected acute viral hepatitis of unknown etiology and for a number of subclinical, unrecognized infections. The overall prevalence of antibody to HHEV is high in most of the former areas and low in most of the later ones, but wide regional differences have been recorded in both cases. “Hot spots” of HHEV infection would exist for both types of strains in particular regions or among particular populations of the world. Studies on pork derivatives, shellfish bivalves, and vegetables for HHEV contamination at the sale point need to be extended for evaluating the impact of the agent on food safety, and the meaning of the finding of HHEV genotype 1 genomes in urban sewage from developed countries should be established through active surveillance. Consensus about technical issues in regard to anti-HEV testing would improve the knowledge of the HHEV epidemiology. Studies in particular regions and populations, and introduction of molecular diagnosis in the clinical setting as a routine tool, would also be required.