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  Hepatitis E

Hepatitis E:

Recently recognized cause of enterically transmitted non-A, non-B hepatitis. This belongs to “Hepatitis E like virus” (that is, former put in calicivirus). It is a spherical, non-enveloped, 27 to 34 nm particles having ssRNA genome.

Pathogenesis:

Identical to hepatitis A; virus replicates in the gut primarily, before invading the liver, and virus is shed in the stool previous to the onset of symptoms. Viraemia is transient. A big inoculum of virus is required to establish infection. Incubation period is 30 to 40 days. Clinical picture represents as self limiting hepatitis, acute, no chronic carrier state exists. Principally affects young adults of age 15 to 40 years.

Complications lead to fulminant hepatitis in pregnant women. The mortality rate is high (i.e., up to 40 percent).

Epidemiology:

A very less is known yet. Large outbreaks have been explained in Mexico, India, and North Africa where the source of infection is generally gross faecal contamination of drinking water supplies. Case-to-case transmission to household contacts appears to be uncommon. This recommends that a large inoculum is required to establish infection.

Laboratory Diagnosis:

No custom laboratory tests are obtainable as yet. Virus can’t be cultured in vitro.

Diagnosis is mainly completed by:

1. Explanation of Calicivirus-like particles in the stool, through electron microscopy. 
2. Particular IgM in serum.
3. PCR HEV-specific series in stool.

 

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