Thickening the Alphabet Soup: The Emergence of Hepatitis E

William F. Balistreri, MD


April 25, 2013

In This Article

Treatment and Prevention

HEV infection is usually self-limited; however, antiviral treatment may be considered in organ transplant recipients with chronic hepatitis E. Pegylated interferon or ribavirin has been reported to induce a rapid reduction in HEV RNA levels in serum, followed by normalization of serum ALT levels and improvement in liver disease.[1,10,22,23,24]

Two separate subunit vaccines have been tested successfully in clinical trials.[2,25,26,27] Zhu and colleagues[27] assessed the efficacy and safety of a recombinant hepatitis E vaccine in a randomized, double-blind, placebo-controlled, phase 3 trial. Vaccine efficacy after 3 doses was 100%, and adverse effects attributable to the vaccine were few and mild.We look forward to the rapid development of vaccine-based strategies for the prevention of hepatitis E.

The Future

With the emergence of HEV, we are able to more precisely narrow the differential of viral-induced liver disease. One request: Let's not call the rest "non-A, non-B, non-C, non-D, non-E hepatitis." Please.