Hepatitis E viruses are single stranded RNA viruses, belonging to the genus hepevirus. This contains hepatitis E viruses infecting humans and other mammals, as well as avian hepatitis E virus. In humans, HEV can cause inflammation of the liver after an incubation period of 2-7 weeks. Disease typically is mild and self-limiting, but mortality up to 20% has been reported among pregnant women, and chronic infection and (severe) hepatitis may occur in immuno-compromised persons. HEV strains infecting mammals are currently classified into genotypes (gt) 1 to 4, and two additional new genotypes have been proposed. Gt 1 and 2 infections are commonly seen as causes of hepatitis in travelers to developing countries, whereas gt 3 and gt 4 were later found as causes of autochthonous infection in industrialized countries. Of these latter two genotypes, especially gt 3 is found to be widespread in commercial pig farms across the world. Underreporting of human HEV infections, and especially those caused by gt 3, is likely. HEV are newly recognized pathogens outside the tropical regions, and the treating physicians may not be aware of these pathogens becoming endemic in industrialized countries. In addition, the currently used diagnostic methods are not optimal. Retrospective studies found HEV infection as possible cause of 6-8% of all non-A-B-C hepatitis cases, and hepatitis E gt 3 is seen in patients without travel history living in regions with endemic HEV in pigs.
http://escv.ivdnews.net/public/show_abstract/1326
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