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International Journal of Infectious Diseases: Volume 2, Number 2
Review: Type E Hepatitis: State of the Art
Mikhail S. Balayan, MD

Int J Infect Dis 1997; 2(2):113-120.

Hepatitis E (HE) occurs predominantly in tropical and semitropical countries in the form of sporadic cases or epidemics of variable magnitude. In industrialized countries, only imported sporadic cases of HE have been reported, with little evidence of human-to-human transmission. HE resembles hepatitis A clinically and epidemiologically but affects young adults rather than children, showing a higher mortality rate in pregnant women. HE virus (HEV) shares many characteristics of the caliciviruses, although it is genomically distinct from this family of viruses. New diagnostic tests have been developed, based on the use of recombinant or synthetic antigens that are analogues of HEV structural proteins. These have been applied to determine the prevalence of antibodies (anti-HEV) in various epidemic and nonepidemic settings. The prevalence of anti-HEV antibodies was unexpectedly low even in endemic areas. A low but constant rate of seropositivity was observed among normal individuals permanently living in nonendemic countries of Europe and North America, while an elevated rate of anti-HEV was found in certain groups of patients and risk groups. This situation as well as other unresolved problems, such as the possible involvement of nonhuman reservoirs, the existence of subclinical forms, and potential prevention strategies, need further investigation.

KEY WORDS: diagnostics, epidemiology, hepatitis E, laboratory models, serologic surveys, viral hepatitis

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