Hepatitis E

(ssRNA; World J Gastro 2016;22:7030; Gastro Clin N Am 2017;46:393)

• Most common cause of acute viral hepatitis in endemic areas

• Transmission: fecal–oral; travelers to central & SE Asia, Africa and Mexico, exposure to swine. ↑ rates of cases in Europe.

• Natural hx: often asx, sometimes causes acute hepatitis w/ ↑ mort. (10–20%) if pregnant; rarely can become chronic in transplant Pts

• Dx: IgM anti-HEV (through CDC), HEV RNA; treatment is generally supportive only

• Extrahepatic sx: arthritis, pancreatitis, anemia, neuro (GBS, meningoencephalitis)