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World J Gastroenterol. Aug 21, 2016; 22(31): 7030-7045
Published online Aug 21, 2016. doi: 10.3748/wjg.v22.i31.7030
Hepatitis E: Discovery, global impact, control and cure
Mohammad S Khuroo, Mehnaaz S Khuroo, Naira S Khuroo
Mohammad S Khuroo, Naira S Khuroo, Digestive Diseases Centre, Dr. Khuroo’s medical Clinic, Srinagar, Kashmir 190010, India
Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir 190010, India
Mehnaaz S Khuroo, Department of Pathology, Govt. Medical College, Srinagar, Kashmir 190001, India
Author contributions: All three authors contributed equally; Khuroo Mehnaaz S and Khuroo NS conducted the literature search; Khuroo Mohammad S wrote the paper; all authors read the paper and made necessary corrections.
Conflict-of-interest statement: The authors report no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mohammad S Khuroo, Director, Digestive Diseases Centre, Dr. Khuroo’s medical Clinic, Sector 1, SK Colony, Qamarwari, Srinagar, Kashmir 190010, India. khuroo@yahoo.com
Telephone: +91-194-2492398 Fax: +91-194-2491190
Received: March 26, 2016
Peer-review started: March 26, 2016
First decision: May 12, 2016
Revised: June 10, 2016
Accepted: July 6, 2016
Article in press: July 6, 2016
Published online: August 21, 2016
Processing time: 142 Days and 4.9 Hours
Abstract

Hepatitis E was identified as an epidemic of non-A, non-B hepatitis from Kashmir, India in 1978. Hepatitis E virus (HEV), the etiological agent is the sole member of family Hepeviridae. The virus has marked heterogeneity and infects many animals like bats, camel, chicken, deer, boar, mongoose, pigs, rats, rabbit and cutthroat trout. Hepatitis E is a disease with a major global impact and has two distinct epidemiological patterns. Hepatitis E is an imperative health issue in developing nations, transmitted through sullied water and happens most every now in young adults. The disease is particularly severe during pregnancy and in people with underlying liver cirrhosis. Autochthonous hepatitis E is increasingly recognized in developed countries. The virus infects domestic pigs, wild boar and Sika deer in these countries. HEV infections in humans occur by eating the undercooked game flesh, raw liver from supermarkets and Figatelli sausages. Blood transfusion-associated HEV infections occur in many countries and screening of donors for HEV RNA is under consideration. Hepatitis E causes a number of extrahepatic diseases, including a wide spectrum of neurological syndromes. HEV genotype 3 causes prolonged viremia, chronic hepatitis, liver fibrosis and cirrhosis in organ transplant patients. The virus is amenable to ribavirin monotherapy and most patients clear the virus in a few weeks. Hepatitis E vaccine -239, marketed in China, has shown high efficacy with sustained protection for over four years.

Keywords: Communicable diseases; Discovery; Hepatitis E; Hepatitis E virus; Vaccine; Zoonosis

Core tip: Discovery of hepatitis E came to lime light when 1978-Kashmir epidemic of hepatitis was investigated. Hepatitis E is being recognized as a clinical entity of reemerging importance. Hepatitis E virus has marked heterogeneity and infects many animals like bats, camel, chicken, deer, boar, mongoose, pigs, rats, rabbit and cutthroat trout. Originally reported as a major health problem in poor-resource countries, hepatitis E is now recognized as an important clinical problem in the developed world. Zoonotic foodborne transmission of hepatitis E virus infections has relevance in solid organ transplant population. Major advances have been made in managing chronic hepatitis E. Hepatitis E causes a number of extrahepatic diseases, including a wide spectrum of neurological syndromes. Hepatitis E vaccine -239, marketed in China, has shown high efficacy with sustained protection for over four years.