Hepatic disorders in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Hepatitis E virus (HEV) is a positive-stranded RNA virus that belongs to the Hepeviridae family. The virus is transmitted via the fecal–oral route, commonly by contaminated water supplies. Vertical transmission of hepatitis E virus ranged between 33% and 50% (33,34). The virus is endemic in the Middle East, India, Southeast Asia, Central Asia, Central America, and South America. Hepatitis E is an acute disease that does not progresses to chronicity, although reports of chronic HEV have been described in liver transplant recipients (35,36). The clinical presentation is basically the same as that for HAV. HEV infection is known to cause severe hepatitis, fulminant liver failure, preterm labor, and increased mortality in pregnant women especially in their third trimester with reported maternal mortality rates as high as 20% to 31.1% (4,37). The incubation period is 3–8 weekes, with a mean of 40 days. Cholestatic hepatitis is common. Acute hepatitis E infection is diagnosed by detection of IgM anti-HEV or a rising titer of IgG anti-HEV. The treatment is supportive therapy. A proved effective vaccine against HEV is currently not available. There is no current evidence that HEV infection is transmitted in breast milk.
Order Hepelivirales
Paul Pumpens, Peter Pushko, Philippe Le Mercier in Virus-Like Particles, 2022
The Hepelivirales order currently involves 4 families, 6 genera, and 22 species. The order includes first the family Hepeviridae with the genera Piscihepevirus—whose members infect fish—and Orthohepevirus, whose members infect mammals and birds. The hepatitis E virus (HEV) of the Orthohepevirus A species is not only a typical representative of the Orthohepevirus genus but also the most dangerous and the most studied virus of the order. HEV is responsible for self-limiting acute hepatitis in humans and several mammalian species, where the infection may become chronic in immunocompromised individuals. Moreover, the extrahepatic manifestations of Guillain-Barré syndrome, neuralgic amyotrophy, glomerulonephritis, and pancreatitis have been described in humans in a proportion of HEV cases. The Orthohepevirus B species includes avian HEV that causes hepatitis-splenomegaly syndrome in chickens (Purdy et al. 2017).
Viral infections in lung transplantation
Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell in LUNG Transplantation, 2016
In developed countries HEV is known as a major cause of hepatitis transmitted via the fecal-oral route.111 HEV is a single-stranded RNA virus belonging to the Hepeviridae family, and in developed countries it is known as a traveler’s disease. Travel-related HEV infection is caused by hepatitis E genotype 1 or 2.112 Genotype 3 has recently been identified as a cause of chronic hepatitis in lung transplant patients and is now recognized as a zoonotic pathogen.113,114
Hepatitis E should be a global public health priority: recommendations for improving surveillance and prevention
Published in Expert Review of Vaccines, 2020
Carl D Kirkwood, Katherine R Dobscha, A Duncan Steele
Hepatitis E virus was first identified in 1981 by Russian virologist Mikhail S. Balayan while investigating an outbreak of enterically transmitted non-A, non-B hepatitis in Russian soldiers stationed in Afghanistan. Balayan self-administered stool extract from the affected soldiers and subsequently developed symptoms of hepatitis. The spherical nonenveloped virus particles were identified in his stool samples analyzed by electron microscopy [10]. HEV is a small, single-stranded, plus sense icosahedral RNA virus, within the Hepeviridae family and genus Orthohepevirus A. It contains a genome of ~7.2 kb, organized in three open reading frames, encoding the structural and nonstructural proteins (Figure 1). HEV is excreted in the feces of infected individuals, is highly infectious, and can persist in the environment. A second, less-infectious, quasi-enveloped form that does not express antigenic proteins is released by host cells into the serum of infected individuals. The capsid and membrane that envelope the viral particles facilitate binding to host cells via normal uptake mechanisms. This envelope is removed in the biliary tract before virus particles are excreted in feces and urine. The nonenveloped particles are 10 times more infectious, which may be due to a different, more efficient host cell entry mechanism [7,11].
Hepatitis E virus genotype 3 is associated with gallstone-related disease
Published in Scandinavian Journal of Gastroenterology, 2019
Miriam Karlsson, Heléne Norder, Maria Bergström, Per-Ola Park, Marie Karlsson, Rune Wejstål, Åsa Alsiö, Anders Rosemar, Martin Lagging, Åsa Mellgren
Hepatitis E virus (HEV) is a small nonenveloped RNA-virus forming the Hepeviridae family. Five genotypes, HEV1-4 and HEV7, are known to infect humans, mainly via fecal-oral transmission [1]. Hepatitis E virus genotype 3 (HEV3) is endemic in Sweden, where the anti-HEV IgG seroprevalence is approximately 17% among blood donors [2]. However, in spite of this high seroprevalence, only 42 clinical cases were notified to The Public Health Agency of Sweden in 2017 [3]. Possible reasons for this large discrepancy include scarce awareness of HEV among clinicians, difficulties in accessing diagnostics, and that HEV3 often is associated with sporadic self-limited acute infections, with up to 70% of cases believed to have a mild or asymptomatic infection [4,5].
Screening, diagnosis and risks associated with Hepatitis E virus infection
Published in Expert Review of Anti-infective Therapy, 2019
Sébastien Lhomme, Florence Legrand-Abravanel, Nassim Kamar, Jacques Izopet
HEV belongs to the Hepeviridae family. This family has 2 genera: Orthohepevirus, which includes 4 species (A-D), and Piscihepevirus (Figure 1). The species Orthohepevirus A includes the HEV strains that infect humans and other mammals. Orthohepevirus B infects chickens, Orthohepevirus C infects rats and ferrets, Orthohepevirus D infects bats and Piscihepevirus A infects cutthroat trout. Orthohepevirus A consists of at least 8 distinct HEV genotypes, but only one serotype has been described [1].
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