Hepatitis E virus (HEV) is a common cause of acute hepatitis worldwide.1,2 HEV infection occurs in two distinct epidemiologic patterns.3 The most common pattern is waterborne infection, which is caused by HEV genotype 1 or 2 and occurs mainly in resource-limited countries, often in large, protracted outbreaks or in sporadic cases associated with high mortality among pregnant women.4-6 The other pattern is transmission from animals and humans, which is caused by HEV genotype 3 or 4 and occurs widely in both resource-limited and developed countries.1,7-9 Rein et al.10 estimated the incidence of hepatitis E in areas in which HEV genotype 1 is endemic to be 3.3 million cases per year, resulting in 70,000 deaths and 3000 stillbirths. This may be an underestimation, because a recent study suggests that, in Bangladesh alone, hepatitis E is responsible for more than 1000 deaths per year among pregnant women.11 An estimation of the burden of disease in developed countries has not been performed. Nevertheless, HEV infection is an important cause of acute viral hepatitis in developed countries.
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Article Source: The New England Journal of Medicine