Hepatitis E virus: advances and challenges

Nat Rev Gastroenterol Hepatol. 2018 Feb;15(2):96-110. doi: 10.1038/nrgastro.2017.150. Epub 2017 Nov 22.

Abstract

At least 20 million hepatitis E virus (HEV) infections occur annually, with >3 million symptomatic cases and ∼60,000 fatalities. Hepatitis E is generally self-limiting, with a case fatality rate of 0.5-3% in young adults. However, it can cause up to 30% mortality in pregnant women in the third trimester and can become chronic in immunocompromised individuals, such as those receiving organ transplants or chemotherapy and individuals with HIV infection. HEV is transmitted primarily via the faecal-oral route and was previously thought to be a public health concern only in developing countries. It is now also being frequently reported in industrialized countries, where it is transmitted zoonotically or through organ transplantation or blood transfusions. Although a vaccine for HEV has been developed, it is only licensed in China. Additionally, no effective, non-teratogenic and specific treatments against HEV infections are currently available. Although progress has been made in characterizing HEV biology, the scarcity of adequate experimental platforms has hampered further research. In this Review, we focus on providing an update on the HEV life cycle. We will further discuss existing cell culture and animal models and highlight platforms that have proven to be useful and/or are emerging for studying other hepatotropic (viral) pathogens.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cells, Cultured
  • Disease Models, Animal
  • Global Health
  • Hepatitis E / epidemiology*
  • Hepatitis E / therapy
  • Hepatitis E / transmission
  • Hepatitis E virus / chemistry
  • Hepatitis E virus / genetics
  • Hepatitis E virus / physiology
  • Hepatocytes / virology
  • Pluripotent Stem Cells / virology
  • Viral Hepatitis Vaccines
  • Viral Proteins / physiology
  • Viral Tropism / physiology
  • Virion / chemistry
  • Virion / physiology

Substances

  • Viral Hepatitis Vaccines
  • Viral Proteins