Published online Feb 21, 2016. doi: 10.3748/wjg.v22.i7.2271
Peer-review started: July 30, 2015
First decision: September 29, 2015
Revised: October 21, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: February 21, 2016
Processing time: 194 Days and 6.7 Hours
Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide. HEV is an RNA-containing virus and the only member of the genus Hepevirus in the family Hepeviridae. Human HEV is classified into four genotypes widely distributed across the world. The virus is mainly transmitted via the fecal-oral route, and water-borne epidemics have become characteristic of hepatitis E in developing countries, including those in Latin America. The zoonotic potential of HEV is broadly recognized. Thus, there is an urgent need to re-evaluate virus transmission scenarios and to enforce epidemiological surveillance systems. Additionally, it is known that HEV infections, initially defined as self-limiting, can also take chronic courses in immunocompromised patients. Moreover, we recently reported a high seroprevalence of HEV in samples from cirrhotic patients with no other etiological agents present, suggesting the potential role of HEV in the development of chronic liver illness. In this review, HEV genomic variability, transmission, chronic infectious course, zoonotic potential and treatment are discussed. Focus is placed on the impact of HEV infection in Latin America, to support the development of specific control strategies and the handling of this important and typically imperceptible viral infection.
Core tip: Despite the widespread presence of hepatitis E virus (HEV), this pathogen is not commonly considered from a global public health perspective. Active research on hepatitis E both in animals and humans has provided novel insight into HEV pathogenesis, zoonotic potential and its role in chronic liver disease. Detailed guidelines for tracking cases need to be developed to contain the virus. This action is particularly necessary in endemic and emerging situations in regions with a higher risk of developing the infection, including Latin America.