The Hepatitis E virus (HEV) is a non-enveloped, single stranded RNA virus primarily transmitted through the fecal-oral route, blood transfusion and possibly maternal-fetal. Infection with HEV causes acute sporadic and epidemic viral Hepatitis and induces acute or subclinical liver diseases similar to Hepatitis A. While there are four major genotypes of HEV, there is only one serotype.
Every year an estimated 20 million HEV infections occur worldwide, leading to more than three million symptomatic cases of Hepatitis E. The World Health Organization estimates that Hepatitis E caused approximately 44 000 deaths in 2015.
While endemic and frequently epidemic HEV infections occur mainly in developing countries with limited or no access to essential water, sanitation, hygiene and health services, the virus has also been observed in developed countries with or without a history of traveling to endemic areas. Data published throughout the last ten years has shown that locally-acquired Hepatitis E in Europe and other developed countries is also common. Persistent HEV infections can occur especially in immune-suppressed cases, e.g. organ transplant recipients or people infected with HIV.
Transmission through the fecal-oral route is common in countries with limited or no access to essential water, sanitation, hygiene and health services. Water and food supplies that are contaminated can lead to major outbreaks. Sporadic cases in countries with better sanitation are often caused by infection through ingestion of undercooked animal meat including animal liver.
HEV transmission by blood transfusion is another route of infection. A study conducted between 2002 and 2008 in China, with 44,816 donor samples, found HEV seroprevalences in blood donors ranged from 29.9% to 41.7%. The rate of acute HEV infection was 0.43% to 1.51%. The viremia rates among the donors in six different regions of China ranged from 0.02% to 0.14%. The results also showed a high prevalence of viremia among anti-HEV IgM-positive samples. A total of 7.14% (30/420) of anti-HEV IgM-positive samples were RNA positive but none of the IgM-negative samples were HEV RNA positive.
Recent seroprevalence studies indicate high prevalence of HEV infection among healthy populations in some industrial countries with historically low occurrence of Hepatitis E including the US, Japan and Europe.
Symptomatic HEV infection is most common in adults aged 15-40 years. Mortality rates for severe forms of Hepatitis E range between 0.5% - 4.0% of the overall population. During pregnancy in the 3rd trimester this severe form of Hepatitis may reach a mortality rate of 20%.
In patients infected with HEV, IgM antibodies typically appear first, followed by IgG seroconversion. The level of IgM antibodies declines rapidly in the acute phase of the infection; the IgG antibodies are present for up to 14 years.
Hepatitis E can be detected using Beijing Wantai’s diagnostic products. Our ELISA kits are intended for use in clinical laboratories for diagnosis and management of the Hepatitis E virus infections while our rapid test delivers a quick result in only 10 minutes. RNA detection with PCR can also be used for diagnosis of HEV infection. Our anti-HEV antigen (Ag)–specific ELISA offers an inexpensive alternative to PCR.
In 2012 the world’s first Hepatitis E vaccine Hecolin® was developed by our subsidiary Innovax [link to Innovax About]. The product Find out more about Hecolin®
