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Hepatitis E: source and route of infection, clinical manifestations and new developments


Correspondence: Harry Dalton, BSc DPhil (Oxon) FRCP, Cornwall Gastrointestinal Unit, Royal Cornwall Hospital, Truro, TR1 3LJ, UK.



Hepatitis E was previously thought to be a disease of developing countries causing significant morbidity and mortality in young adults, particularly among pregnant women and patients with pre-existing chronic liver disease. Recent studies have shown that hepatitis E is also an issue in developed countries. In this setting, hepatitis E is a zoonotic infection and causes acute infection mainly in middle-aged and elderly men; and chronic infection in the immunosuppressed. The scope and burden of disease are still emerging. The diagnosis of hepatitis E should be considered in any patient with hepatitis, irrespective of their age or travel history.